Predictive Role of Coagulation, Fibrinolytic, and Endothelial Markers in Patients with Atrial Fibrillation, Stroke, and Thromboembolism: A Meta-Analysis, Meta-Regression, and Systematic Review.
Year: 2017
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: 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.
Source: Europe PMC (PubMed Central)
Authors: Alexander Weymann, Anton Sabashnikov, Sadeq Ali-Hasan-Al-Saegh, Aron-Frederik Popov, Seyed Jalil Mirhosseini, William L Baker, Mohammadreza Lotfaliani, Tong Liu, Hamidreza Dehghan, Senol Yavuz, Michel Pompeu Barros de Oliveira Sá, Jae-Sik Jang, Mohamed Zeriouh, Lei Meng, Fabrizio D'Ascenzo, Abhishek J Deshmukh, Guiseppe Biondi-Zoccai, Pascal M Dohmen, Hugh Calkins, Integrated Meta-Analysis Of Cardiac Cardiac Surgery And Cardiology-Group Imcsc-Group
Institutions: Carl von Ossietzky Universität Oldenburg, Royal Brompton & Harefield NHS Foundation Trust, Harefield Hospital, University Hospital Cologne, Shahid Sadoughi University of Medical Sciences and Health Services, University Hospital Frankfurt, Hartford Hospital, University of Connecticut, Second Hospital of Tianjin Medical University, Tianjin Medical University, S.B.Ü. Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Universidade de Pernambuco, Inje University, Inje University Busan Paik Hospital, University of Turin, Mayo Clinic, Istituto Neurologico Mediterraneo, Sapienza University of Rome, Johns Hopkins University, Johns Hopkins Medicine
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2606602370