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Brezinov OP, Sevilya Z, Yahud E, Rahkovich M, Kogan Y, Marincheva G, Kakzanov Y, Lev E, Laish-Farkash A. Comparison of Immature Platelet Fraction and Factors Associated with Inflammation, Thrombosis and Platelet Reactivity Between Left and Right Atria in Patients with Atrial Fibrillation. J Atr Fibrillation 2021; 13:2459. [PMID: 34950336 DOI: 10.4022/jafib.2459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 12/25/2020] [Accepted: 01/18/2021] [Indexed: 11/10/2022]
Abstract
Background Recent trials found poor temporal relationship between atrial fibrillation (AF) episodes and strokes. Thus, stroke in AF patients probably involves more mechanisms than cardiac embolism. We compared factors of inflammation, thrombosis and platelet reactivity between left (LA) and right atria (RA) and femoral vein (FV) in patients with AF. Methods Blood samples were collected from patients undergoing AF-ablation from the FV, RA and LA for neutrophil to lymphocyte ratio (NLR), immature platelet fraction (IPF) and count (IPC), CD40 ligand, P-selectin and E-Selectin. IPF was measured by an autoanalyzer; CD40 ligand, P-selectin, and E-Selectin were measured by ELISA and NLR was calculated from complete blood counts. Results Sixty-seven patients were included (age 65±10y, 63% male, CHA2DS2-VASc score 2.8±1.8, LA volume index 40±24 mL/m2, 63% paroxysmal AF). There was no difference between FV, RA and LA regarding NLR and CD40 ligand. Factors associated with platelets activity: P-selectin, IPC and IPF% were higher in RA vs LA (60.3 IQR 49.0-76.4 ng/ml vs. 59.3 IQR 49.0-74.7, respectively, p=0.03 for P-selectin, 7.5 IQR 5.2-10 103/μL vs. 7.1 IQR 5-9.8, p<0.01 for IPC, and 3.6 IQR 2.7-5.0 % vs. 3.6 IQR 2.6-4.8, p<0.01 for IPF%). Similar trends were for E-selectin (41.2 IQR 31.1-51.2 ng/mL vs. 38.7 IQR 27.9-50.4 p=0.09). Similar significant differences were found in patients with CHA2DS2-VASC≥2 but not in patients with low score. Conclusions Patients with AF, especially those with CHA2DS2-VASc≥2, have higher markers of thrombogenicity in RA compared to LA. There was no difference in inflammatory properties between the atria.
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Affiliation(s)
- Olga Perelshtein Brezinov
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Ziv Sevilya
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Ella Yahud
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Michael Rahkovich
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Yonatan Kogan
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Gergana Marincheva
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Yana Kakzanov
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Eli Lev
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Avishag Laish-Farkash
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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