The Effects Of The Differenceent Clinic Factors On The Blood Clotting Function In Patients With Chronic Non-valvular Atrial Fibrillation

Objective: to observe the effect of various clinic factors on blood cloting function in patients with chronic non-valvular atrial fibrillation(NVAF) by measuringblood clotting factors in plasma.Methods: 60 patients with chronic NVAF and 20 normal controls were recruited, without anticoagulant treatment.vonWillebrand factor concentrations (vWF,as an indice of endothelial dysfunction) and fibrin D-dimer concentrations (D-D,asan index of thrombogenesis) and fibrinogen(Fg) concentrations were measured.The patients were divided into two groups according to age(<70year or≥70 year)or according to left atrial diamater(<40mm or≥40mm) or according to blood sugar(<7.0mmol/l or≥7.0 mol/l) or according to NYHA classied(NYHA<3 or≥NYHA3) or according to blood pressure(SBP≥140mmHg and/orDBP≥90mmHg ornot), paroxysmal atrial fibrillation (PAf) or non-paroxysmal atrial fibrillation(NPAf),then compare the vwf,D-D and Fg concentrations between the groups.Results:Patients with chronic NVAF had higher concentrations of vwf,D-D andFg than the controls(all P<0.001), aged patients(≥70year)has higher concentrations of vwf,D-D and Fg than younger patients (<70year)(P<0.01,P<0.05,P<0.05 respectively),so did between patients with left atrial diamater≥40mm and patients with left atrial diamater<40mm(P<0.001,P<0.001,P<0.01 respectively), between patients with diabetes mellitus(DM)and without DM(P<0.01,P<0.05,P>0.05 respectively),between patients with hypertension and without hypertension(P<0.05,P<0.05,P<0.01 respectively), between patients with NYHA≥3 and NYHA1(P<0.01,P<0.01,P<0.05 respectively),when adjusted by LA diamater there was no signifcent difference between patients with NYHA≥3 and NYHA1(all P>0.05).But there was no signifcent difference between patients with PAf an d non-PAf(all P>0.05).Conclusions:1, There was evidence of prothrombotic state among patients with NVAF, which had higher concentrations of vwf, D-D and Fg than the controls.2, LA enlargement,aging,DM and hypertension all are risks of increased thromboembolia among patients with NVAF.3, Severe heart dysfunction may not be a risk of increased thromboembolia amongpatients with NVAF, patients with NYHA≥3 had higher concentrations of vwf,D-D and Fg than patients with NYHA1, but it's no signifcent differenceafter adjusted by LA diamater.4, There was no signifcent difference in concentrations of vwf,D-D and Fg betwee patients with PAf and non-PAf, but all higher than controls signifcentlyin the other words, PAf had the same risk of thromboembolia as chronic non-PAf.