TY - JOUR
T1 - Predictive Role of Coagulation, Fibrinolytic, and Endothelial Markers in Patients with Atrial Fibrillation, Stroke, and Thromboembolism
T2 - A Meta-Analysis, Meta-Regression, and Systematic Review
AU - Weymann, Alexander
AU - Sabashnikov, Anton
AU - Ali-Hasan-Al-Saegh, Sadeq
AU - Popov, Aron-Frederik
AU - Jalil Mirhosseini, Seyed
AU - Baker, William L
AU - Lotfaliani, Mohammadreza
AU - Liu, Tong
AU - Dehghan, Hamidreza
AU - Yavuz, Senol
AU - de Oliveira Sá, Michel Pompeu Barros
AU - Jang, Jae-Sik
AU - Zeriouh, Mohamed
AU - Meng, Lei
AU - D'Ascenzo, Fabrizio
AU - Deshmukh, Abhishek J
AU - Biondi-Zoccai, Guiseppe
AU - Dohmen, Pascal M
AU - Calkins, Hugh
AU - Cardiac Surgery And Cardiology-Group Imcsc-Group, Integrated Meta-Analysis Of Cardiac
PY - 2017/3/31
Y1 - 2017/3/31
N2 - BACKGROUND The pathophysiological mechanism associated with the higher prothrombotic tendency in atrial fibrillation (AF) is complex and multifactorial. However, the role of prothrombotic markers in AF remains inconclusive. MATERIAL AND METHODS We conducted a meta-analysis of observational studies evaluating the association of coagulation activation, fibrinolytic, and endothelial function with occurrence of AF and clinical adverse events. A comprehensive subgroup analysis and meta-regression was performed to explore potential sources of heterogeneity. RESULTS A literature search of major databases retrieved 1703 studies. After screening, a total of 71 studies were identified. Pooled analysis showed the association of coagulation markers (D-dimer (weighted mean difference (WMD) =197.67 and p<0.001), fibrinogen (WMD=0.43 and p<0.001), prothrombin fragment 1-2 (WMD=0.53 and p<0.001), antithrombin III (WMD=23.90 and p=0.004), thrombin-antithrombin (WMD=5.47 and p=0.004)); fibrinolytic markers (tissue-type plasminogen activator (t-PA) (WMD=2.13 and p<0.001), plasminogen activator inhibitor (WMD=11.44 and p<0.001), fibrinopeptide-A (WMD=4.13 and p=0.01)); and endothelial markers (von Willebrand factor (WMD=27.01 and p<0.001) and soluble thrombomodulin (WMD=3.92 and p<0.001)) with AF. CONCLUSIONS The levels of coagulation, fibrinolytic, and endothelial markers have been reported to be significantly higher in AF patients than in SR patients.
AB - BACKGROUND The pathophysiological mechanism associated with the higher prothrombotic tendency in atrial fibrillation (AF) is complex and multifactorial. However, the role of prothrombotic markers in AF remains inconclusive. MATERIAL AND METHODS We conducted a meta-analysis of observational studies evaluating the association of coagulation activation, fibrinolytic, and endothelial function with occurrence of AF and clinical adverse events. A comprehensive subgroup analysis and meta-regression was performed to explore potential sources of heterogeneity. RESULTS A literature search of major databases retrieved 1703 studies. After screening, a total of 71 studies were identified. Pooled analysis showed the association of coagulation markers (D-dimer (weighted mean difference (WMD) =197.67 and p<0.001), fibrinogen (WMD=0.43 and p<0.001), prothrombin fragment 1-2 (WMD=0.53 and p<0.001), antithrombin III (WMD=23.90 and p=0.004), thrombin-antithrombin (WMD=5.47 and p=0.004)); fibrinolytic markers (tissue-type plasminogen activator (t-PA) (WMD=2.13 and p<0.001), plasminogen activator inhibitor (WMD=11.44 and p<0.001), fibrinopeptide-A (WMD=4.13 and p=0.01)); and endothelial markers (von Willebrand factor (WMD=27.01 and p<0.001) and soluble thrombomodulin (WMD=3.92 and p<0.001)) with AF. CONCLUSIONS The levels of coagulation, fibrinolytic, and endothelial markers have been reported to be significantly higher in AF patients than in SR patients.
KW - Atrial Fibrillation
KW - Biomarkers
KW - Blood Coagulation Factors
KW - Fibrin Fibrinogen Degradation Products
KW - Fibrinolytic Agents
KW - Humans
KW - Stroke
KW - Thromboembolism
KW - Tissue Plasminogen Activator
KW - Journal Article
KW - Meta-Analysis
KW - Review
U2 - 10.12659/MSMBR.902558
DO - 10.12659/MSMBR.902558
M3 - Review article
C2 - 28360407
VL - 23
SP - 97
EP - 140
JO - Medical science monitor basic research
JF - Medical science monitor basic research
SN - 2325-4394
ER -