Abstract
Background: P-selectin - a biomarker of platelet and endothelial cell activation is elevated in patients with non-valvular atrial fibrillation (NVAF). However, the association between sP-selectin level and thromboembolic complications in NVAF patients remains controversial. We tested the hypothesis that plasma soluble P-selectin (sPSL) level correlates with the measures of left atrial blood stasis in NVAF. Methods: Plasma sPSL concentration was measured using solid-phase ELISA in 103 NVAF patients (age 63 ± 14 years; 26% women) and 48 normal sinus rhythm controls (NSR; age 64 ± 14 years; 41% women) who were not on aspirin. Within the group of NVAF cases, 27 had no spontaneous echocardiographic contrast (SEC) detected by transesophageal echocardiography, 31had mild SEC, 15 moderate, 20 severe, and 10 patients had left atrial appendage thrombus (LAAT). Results: The median soluble sPSL level was higher in NVAF cases compared to NSR controls [(interquartile range) 26 (20−32) ng/mL vs 22 (15–29) ng/mL, p = 0.0045]. Only NVAF patients with CHA2DS2-VASc score ≥ 1 had higher sPSL level compared to NSR controls. Patients with severe SEC had significantly higher sPSL levels [32 (24–38) ng/mL] compared to all other NVAF patients (p = 0.0042) and to NSR controls (p < 0.0001). Also NVAF patients with LAAT had higher sPSL level compared to NSR controls. Conclusions: There is a direct correlation between p-selectin level and severe blood stasis in the left atrium. Only NVAF patients with CHA2DS2-VASc score ≥ 1 or with LAAT had higher sPSL level compared to NSR controls.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 4-8 |
| Number of pages | 5 |
| Journal | Thrombosis Research |
| Volume | 172 |
| DOIs | |
| State | Published - Dec 1 2018 |
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Keywords
- Atrial fibrillation
- Left atrial appendage thrombus
- Soluble P-selection
ASJC Scopus subject areas
- Hematology
Cite this
Association between P-selectin levels and left atrial blood stasis in patients with nonvalvular atrial fibrillation. / Wysokinski, W. E.; Cohoon, K. P.; Melduni, Rowlens; Mazur, M.; Ammash, N.; Munger, T.; Konik, E.; McLeod, T.; Gosk-Bierska, Izabeal; McBane, Robert D.
In: Thrombosis Research, Vol. 172, 01.12.2018, p. 4-8.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Association between P-selectin levels and left atrial blood stasis in patients with nonvalvular atrial fibrillation
AU - Wysokinski, W. E.
AU - Cohoon, K. P.
AU - Melduni, Rowlens
AU - Mazur, M.
AU - Ammash, N.
AU - Munger, T.
AU - Konik, E.
AU - McLeod, T.
AU - Gosk-Bierska, Izabeal
AU - McBane, Robert D
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Background: P-selectin - a biomarker of platelet and endothelial cell activation is elevated in patients with non-valvular atrial fibrillation (NVAF). However, the association between sP-selectin level and thromboembolic complications in NVAF patients remains controversial. We tested the hypothesis that plasma soluble P-selectin (sPSL) level correlates with the measures of left atrial blood stasis in NVAF. Methods: Plasma sPSL concentration was measured using solid-phase ELISA in 103 NVAF patients (age 63 ± 14 years; 26% women) and 48 normal sinus rhythm controls (NSR; age 64 ± 14 years; 41% women) who were not on aspirin. Within the group of NVAF cases, 27 had no spontaneous echocardiographic contrast (SEC) detected by transesophageal echocardiography, 31had mild SEC, 15 moderate, 20 severe, and 10 patients had left atrial appendage thrombus (LAAT). Results: The median soluble sPSL level was higher in NVAF cases compared to NSR controls [(interquartile range) 26 (20−32) ng/mL vs 22 (15–29) ng/mL, p = 0.0045]. Only NVAF patients with CHA2DS2-VASc score ≥ 1 had higher sPSL level compared to NSR controls. Patients with severe SEC had significantly higher sPSL levels [32 (24–38) ng/mL] compared to all other NVAF patients (p = 0.0042) and to NSR controls (p < 0.0001). Also NVAF patients with LAAT had higher sPSL level compared to NSR controls. Conclusions: There is a direct correlation between p-selectin level and severe blood stasis in the left atrium. Only NVAF patients with CHA2DS2-VASc score ≥ 1 or with LAAT had higher sPSL level compared to NSR controls.
AB - Background: P-selectin - a biomarker of platelet and endothelial cell activation is elevated in patients with non-valvular atrial fibrillation (NVAF). However, the association between sP-selectin level and thromboembolic complications in NVAF patients remains controversial. We tested the hypothesis that plasma soluble P-selectin (sPSL) level correlates with the measures of left atrial blood stasis in NVAF. Methods: Plasma sPSL concentration was measured using solid-phase ELISA in 103 NVAF patients (age 63 ± 14 years; 26% women) and 48 normal sinus rhythm controls (NSR; age 64 ± 14 years; 41% women) who were not on aspirin. Within the group of NVAF cases, 27 had no spontaneous echocardiographic contrast (SEC) detected by transesophageal echocardiography, 31had mild SEC, 15 moderate, 20 severe, and 10 patients had left atrial appendage thrombus (LAAT). Results: The median soluble sPSL level was higher in NVAF cases compared to NSR controls [(interquartile range) 26 (20−32) ng/mL vs 22 (15–29) ng/mL, p = 0.0045]. Only NVAF patients with CHA2DS2-VASc score ≥ 1 had higher sPSL level compared to NSR controls. Patients with severe SEC had significantly higher sPSL levels [32 (24–38) ng/mL] compared to all other NVAF patients (p = 0.0042) and to NSR controls (p < 0.0001). Also NVAF patients with LAAT had higher sPSL level compared to NSR controls. Conclusions: There is a direct correlation between p-selectin level and severe blood stasis in the left atrium. Only NVAF patients with CHA2DS2-VASc score ≥ 1 or with LAAT had higher sPSL level compared to NSR controls.
KW - Atrial fibrillation
KW - Left atrial appendage thrombus
KW - Soluble P-selection
UR - http://www.scopus.com/inward/record.url?scp=85054811446&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85054811446&partnerID=8YFLogxK
U2 - 10.1016/j.thromres.2018.10.009
DO - 10.1016/j.thromres.2018.10.009
M3 - Article
C2 - 30340092
AN - SCOPUS:85054811446
VL - 172
SP - 4
EP - 8
JO - Thrombosis Research
JF - Thrombosis Research
SN - 0049-3848
ER -