Vitamin K antagonists favourably modulate fibrin clot properties in patients with atrial fibrillation as early as after 3days of treatment: Relation to coagulation factors and thrombin generation

Thrombosis Research
Michal ZąbczykAnetta Undas

Abstract

Atrial fibrillation (AF) increases the risk of thromboembolism that is reduced by vitamin K antagonists (VKAs). We sought to investigate changes in plasma fibrin clot phenotype at the onset of oral anticoagulation. Forty consecutive AF patients (aged 45-83 years, CHA2DS2-VASc score 3.0±1.5) who started therapy with warfarin or acenocoumarol were studied. Plasma fibrin clot permeability (Ks), clot lysis time (CLT), along with clotting factors (F), thrombin generation (TG) profiles and protein C (PC) levels were determined on days 3, 5, 7, 28 and 56±1 since the first dose. AF patients had 16% higher median of Ks and 15% lower median of CLT as early as on day 3 of VKA therapy compared with the baseline (both p<0.001), reaching the plateau values on day 7 and 5, respectively. Higher Ks values on days 1 and 3 were found in AF patients with further stable anticoagulation (both p<0.05). Moreover, FIX explained 32% of the total variability in Ks. Multivariate analysis adjusted for potential confounders including time as a predictor showed that vitamin K-dependent (VKD) factors, PC and TG parameters were the predictors of Ks (all p<0.0001), while only the lag phase of TG and thrombin peak predicted CLT (both p<0.05) in AF patients. Regr...Continue Reading

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Citations

Sep 15, 2017·Stroke; a Journal of Cerebral Circulation·Leszek DrabikAnetta Undas
Jun 5, 2019·Expert Review of Hematology·Anetta Undas, Joanna Natorska
Oct 19, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Anetta Undas
Jan 24, 2021·Cardiovascular Research·Wern Yew DingGregory Y H Lip
Apr 21, 2021·Seminars in Thrombosis and Hemostasis·Anetta Undas

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