Impaired fibrinolysis in patients with atrial fibrillation and elevated circulating lipopolysaccharide.

Autor: Sadowski M; Collegium Medicum, Jan Kochanowski University, Kielce, Poland., Ząbczyk M; Department of Thromboembolic Disorders, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland.; Krakow Centre for Medical Research and Technologies, John Paul II Hospital, Krakow, Poland., Undas A; Department of Thromboembolic Disorders, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland. mmundas@cyf-kr.edu.pl.; Krakow Centre for Medical Research and Technologies, John Paul II Hospital, Krakow, Poland. mmundas@cyf-kr.edu.pl.
Jazyk: angličtina
Zdroj: Journal of thrombosis and thrombolysis [J Thromb Thrombolysis] 2024 Jun; Vol. 57 (5), pp. 842-851. Date of Electronic Publication: 2024 Apr 21.
DOI: 10.1007/s11239-024-02980-5
Abstrakt: It is unknown whether elevated gut-derived serum lipopolysaccharide (LPS) can affect thrombin generation, fibrinolysis, and fibrin clot properties in atrial fibrillation (AF). We aimed to evaluate associations of circulating LPS with prothrombotic markers in AF patients. A total of 157 (women, 57.3%) ambulatory anticoagulant-naïve AF patients aged from 42 to 86 years were recruited. Clinical data together with serum LPS, inflammation, endothelial injury, coagulation and fibrinolysis markers, including fibrin clot permeability (K s ) and clot lysis time (CLT), were analyzed. A median LPS concentration was 73.0 (58.0-100.0) pg/mL and it showed association with CLT (r = 0.31, p < 0.001) and plasminogen activator inhibitor-1 (PAI-1, r = 0.57, p < 0.001), but not other fibrinolysis proteins, thrombin generation, inflammatory markers, or K s . There were weak associations of LPS with von Willebrand factor (vWF, r = 0.2, p = 0.013), cardiac troponin I (r = 0.16, p = 0.045), and growth differentiation factor-15 (r = 0.27, p < 0.001). No associations of LPS and CHA 2 DS 2 -VASc or other clinical variables were observed. Multivariable regression adjusted for potential confounders showed that serum LPS ≥ 100 pg/mL was an independent predictor of prolonged CLT. This study is the first to demonstrate antifibrinolytic effects of elevated LPS in AF patients largely driven by enhanced PAI-1 release.
(© 2024. The Author(s).)
Databáze: MEDLINE
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