Difference in left atrial D-dimer level in patients with atrial fibrillation treated with direct oral anticoagulant
| Autor: | Tomoko Minamisaka, Yukinori Shinoda, Tetsuya Watanabe, Souki Inoue, Keisuke Ueno, Kentaro Mine, Hirooki Inui, Hidetada Fukuoka, Koichi Tachibana, Shiro Hoshida |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Pyridines Pyridones Administration Oral Antithrombins Pulmonary vein Dabigatran Direct oral anticoagulants Fibrin Fibrinogen Degradation Products chemistry.chemical_compound Edoxaban Internal medicine D-dimer medicine Diseases of the circulatory (Cardiovascular) system Humans Prospective Studies Aged business.industry Atrial fibrillation Venous blood Middle Aged medicine.disease Thrombosis Thiazoles Treatment Outcome chemistry RC666-701 Left atrium Cardiology Pyrazoles Apixaban Female Cardiology and Cardiovascular Medicine business Biomarkers medicine.drug Research Article Factor Xa Inhibitors |
| Zdroj: | BMC Cardiovascular Disorders BMC Cardiovascular Disorders, Vol 21, Iss 1, Pp 1-7 (2021) |
| ISSN: | 1471-2261 |
| Popis: | Background Atrial fibrillation (AF) may cause cerebral and systemic embolism. An increased D-dimer level indicates hyperactivation of secondary fibrinolysis, resulting in predilection for thrombosis. To clarify the differential effects of anticoagulation therapy, we compared the D-dimer levels in peripheral and left atrial (LA) blood of atrial fibrillation patients scheduled for ablation. Methods We analyzed 141 patients with non-valvular AF (dabigatran, n = 30; apixaban, n = 47; edoxaban, n = 64; mean age: 68 years, male: 60%). Peripheral venous blood and LA blood was collected before pulmonary vein isolation. We examined the laboratory and echocardiographic parameters. Results After adjusting for baseline characteristics, D-dimer level in the LA was significantly higher in patients treated with edoxaban than that in those on apixaban (0.77 ± 0.05 vs. 0.60 ± 0.05 μg/mL, P = 0.047), although there were no significant differences in peripheral D-dimer levels. We classified the D-dimer value of the LA into a normal group (P = 0.008) and left ventricular ejection fraction (LVEF) (OR, 0.947; 95% CI, 0.910–0.986; P = 0.008) were potential predictors of high LA D-dimer levels. Conclusions In apixaban-treated patients, the D-dimer level in the left atrium was lower than in edoxaban-treated patients on the day of ablation, suggesting that the anticoagulant effect of apixaban on the left atrium is better than that of edoxaban in patients with AF. |
| Databáze: | OpenAIRE |
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