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Hemostatic markers are associated with the risk and prognosis of atrial fibrillation: the ARIC study.

TitleHemostatic markers are associated with the risk and prognosis of atrial fibrillation: the ARIC study.
Publication TypeJournal Article
Year of Publication2012
AuthorsAlonso A, Tang W, Agarwal SK, Soliman EZ, Chamberlain AM, Folsom AR
JournalInt J Cardiol
Volume155
Issue2
Pagination217-22
Date Published2012 Mar 08
ISSN1874-1754
KeywordsAntithrombin III, Atrial Fibrillation, Biomarkers, Brain Ischemia, Factor VII, Factor VIII, Female, Fibrinogen, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Partial Thromboplastin Time, Prognosis, Protein C, Risk Factors, Stroke, von Willebrand Factor
Abstract

BACKGROUND: Various hemostatic markers are associated with the risk of cardiovascular disease; however, limited information exists on their relationship with the occurrence and prognosis of atrial fibrillation (AF).

OBJECTIVES: To assess whether hemostatic markers are associated with the incidence and prognosis of AF.

METHODS: We studied 14,858 men and women in the Atherosclerosis Risk in Communities cohort, aged 45-64 and free of AF at baseline (1987-1989). Fibrinogen, von Willebrand factor (vWf), factor VII activity (VIIc), factor VIII activity (VIIIc), protein C, antithrombin III (ATIII), and activated partial thromboplastin time (aPTT) were measured in blood samples at baseline. AF and other cardiovascular outcomes through 2005 were determined following standardized protocols.

RESULTS: During a median follow-up of 16.8 years, 1209 cases of AF were identified. In multivariable Cox models, the hazard ratios (HR) and 95% confidence intervals (CI) of incident AF associated with a 1-standard deviation (SD) increase in each marker were 1.13 (1.07-1.20) for fibrinogen, 1.17 (1.11-1.23) for vWf, 1.17 (1.11-1.24) for factor VIIIc, 0.93 (0.88-1.00) for factor VIIc, 0.98 (0.92-1.04) for protein C, 1.00 (0.94-1.06) for aPTT and 1.00 (0.95-1.06) for ATIII. Greater factor VIIIc, fibrinogen and vWf were consistently associated with a higher risk of cardiovascular outcomes and mortality in those with and without incident AF, while greater protein C was associated with a lower risk of ischemic stroke.

CONCLUSION: Several hemostatic markers are associated with the incidence of AF independently of other cardiovascular risk factors. Their role in the risk stratification of AF patients should be further studied.

DOI10.1016/j.ijcard.2010.09.051
Alternate JournalInt J Cardiol
PubMed ID20965585
PubMed Central IDPMC3025309
Grant ListN01HC55020 / HL / NHLBI NIH HHS / United States
N01 HC055022 / HC / NHLBI NIH HHS / United States
N01HC55018 / HL / NHLBI NIH HHS / United States
RC1HL099452 / HL / NHLBI NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
N01 HC055018 / HC / NHLBI NIH HHS / United States
RC1 HL099452 / HL / NHLBI NIH HHS / United States
N01HC55022 / HL / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
N01HC55015 / HL / NHLBI NIH HHS / United States
N01 HC055019 / HC / NHLBI NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
N01-HC-55015 / HC / NHLBI NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
N01HC55016 / HL / NHLBI NIH HHS / United States
N01 HC055015 / HC / NHLBI NIH HHS / United States
N01 HC055021 / HC / NHLBI NIH HHS / United States
RC1 HL099452-02 / HL / NHLBI NIH HHS / United States
N01HC55019 / HL / NHLBI NIH HHS / United States
RC1 HL099452-01 / HL / NHLBI NIH HHS / United States
N01 HC055020 / HC / NHLBI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
N01HC55021 / HL / NHLBI NIH HHS / United States
N01 HC055016 / HC / NHLBI NIH HHS / United States