The Changes And Clinical Significances Of Plasma Levels Of Thrombin-antithrombin III Complexes And D-dimer In Patients With Non-valvular Atrial Fibrillation And Chronic Heart Failure

ObjectivesThe aims of this study were to investigate the changes of plasma thrombin-antithrombinⅢcomplexes(TAT)and D-dimer(DD)levels and to explore the clinical significances of these coagulation markers in evaluating prothrombotic state in patients with non-valvular atrial fibrillation(NVAF)and chronic heart failure(CHF)with sinus rhythm.MethodsFasting blood samples were collected from hospital-based patients with documented NVAF(n=33)and CHF with sinus rhythm(n=30)and controls(n=25),respectively.Plasma TAT and DD were measured by enzyme-linked immunosorbent assay(ELISA)in all groups.The correlations of the embolic risk and the levels of TAT and DD in patients with NVAF and CHF with sinus rhythm were analyzed by linear correlation and spearman correlation.Results1.The plasma levels of TAT(4.98±0.92ng/ml VS 2.21±0.50 ng/ml, P＜0.01)and DD(0.42±0.08ug/ml VS 0.14±0.02ug/ml,P＜0.01)in patients with NVAF were significantly higher than those in the control group,respectively. 2.The plasma levels of TAT(4.66±0.95ng/ml VS 2.21±0.50ng/ml,P＜0.01)and DD(0.38±0.09ug/ml VS 0.14±0.02ug/ml,P＜0.01)in patients with CHF with sinus rhythm were significantly higher those of the control group,respectively.3.There were positive correlations between the plasma levels of TAT and DD and NYHA,left atrial diameter(LAD),c-reactive protein(CRP), fibrinogen(Fg),hight density lipoprotein-cholesterol(HDL-C),while there were negative correlations between the plasma levels of TAT and DD and left ventricular ejection fraction(LVEF).Conclusions1.The patients with non-valvular atrial fibrillation(NVAF)show evidence of prothrombotic state.2.The patients with chronic heart failure(CHF)with sinus rhythm show evidence of prothrombotic state.3.The patients with non-valvular atrial fibrillation complicated chronic heart failure show a prothrombotic state and the changes become more dramatic in association with worsening of heart failure.4.The plasma level of TAT can reflect the prothrombotic state of patients with non-valvular atrial fibrillation(NVAF)and chronic heart failure(CHF)with sinus rhythm and with non-valvular atrial fibrillation complicated chronic heart failure.