In:
EP Europace, Oxford University Press (OUP), Vol. 25, No. 1 ( 2023-02-08), p. 28-39
Abstract:
While atrial fibrillation (AF) is suggested to induce a prothrombotic state, increasing thrombotic risk, it is also hypothesized that coagulation underlies AF onset. However, conclusive evidence is lacking. With this systematic review and meta-analysis, we aimed to summarize and combine the evidence on the associations between coagulation factors with AF in both longitudinal and cross-sectional studies. Methods and results We systematically searched for longitudinal cohort and cross-sectional studies investigating AF and thrombosis. For longitudinal studies, pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. For cross-sectional studies, we determined pooled standardized mean differences (SMDs) and 95% CIs. A total of 17 longitudinal and 44 cross-sectional studies were included. In longitudinal studies, we found significant associations between fibrinogen (HR 1.05, 95% CI 1.00–1.10), plasminogen activator inhibitor 1 (PAI-1) (HR 1.06, 95% CI 1.00–1.12), and D-dimer (HR 1.10, 95% CI 1.02–1.19) and AF incidence. In cross-sectional studies, we found significantly increased levels of fibrinogen (SMD 0.47, 95% CI 0.20–0,74), von Willebrand factor (SMD 0.96, 95% CI 0.28–1.66), P-selectin (SMD 0.31, 95% CI 0.08–0.54), ß-thromboglobulin (SMD 0.82, 95% CI 0.61–1.04), Platelet Factor 4 (SMD 0.42, 95% CI 0.12–0.7), PAI-1 (1.73, 95% CI 0.26–3.19), and D-dimer (SMD 1.74, 95% CI 0.36–3.11) in AF patients, as opposed to controls. Conclusion These findings suggest that higher levels of coagulation factors are associated with prevalent and incident AF. These associations are most pronounced with prevalent AF in cross-sectional studies. Limited evidence from longitudinal studies suggests a prothrombotic state underlying AF development.
Type of Medium:
Online Resource
ISSN:
1099-5129
,
1532-2092
DOI:
10.1093/europace/euac130
Language:
English
Publisher:
Oxford University Press (OUP)
Publication Date:
2023
detail.hit.zdb_id:
2002579-8
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