oa Molecular Diagnosis and Vaccines - Soluble P-selectin level as a predictor of prothrombotic status in patients with atrial fibrillation
The increased risk of thromboembolism in atrial fibrillation (AF) may be related to a prothrombotic or hypercoagulable state, with abnormalities of hemostasis and platelet activation. P-selectin is an adhesion molecule that is expressed by platelets on activation and soluble P-selectin (sP-selectin) level is now considered a reliable marker of in vivo platelet activation. We investigated the value of sP-selectin level as a marker of prothrombotic state in patients with AF. Thirty patients with documented permanent AF (16 males, 14 females, mean age 5611.8 years) were subjected to transthoracic (TTE) and transesophageal (TEE) echocardiographic studies. sP-selectin level was measured using ELISA in these patients and in 12 age matched healthy controls. Results revealed a significant elevation of sP-selectin levels in patients with AF as compared to control group (16139 ng/ml vs. 16.7 8.9 ng/ml, respectively), (P<0.001), in spite of proper anticoagulation. In the patient group, significant elevation in sP-Selectin levels was noted in patients with diabetes mellitus (17639 ng/ml), as compared to non-diabetic patients (150.936.6 ng/ml) (P<0.05). The presence of spontaneous echo contrast (SEC) or left atrial thrombus in TEE was associated with significant elevation of sP-selectin levels, as compared to those of patients having none of these findings (179.8 36.8 ng/ml vs. 130.523.1 ng/ml, respectively), (P<0.01). Platelet activation occurs as part of the prothrombotic status in patients with AF in spite of proper anticoagulation. Determination of sP-selectin level may provide a useful noninvasive marker to identify AF patients at high thromboembolic risk.
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