Stroke, Vol 21, 47-51, Copyright © 1990 by American Heart Association
C Gustafsson, M Blomback, M Britton, A Hamsten and J Svensson
We studied whether hemostatic abnormalities contribute to the increased
risk of stroke in patients with nonvalvular atrial fibrillation. Hemostatic
function was studied in four age-matched groups: 20 patients with
nonvalvular atrial fibrillation and a previous ischemic stroke, 20 patients
with nonvalvular atrial fibrillation without a previous stroke, 20 stroke
patients with sinus rhythm, and 40 healthy controls. Both groups with
nonvalvular atrial fibrillation had significantly higher concentrations of
von Willebrand factor, factor VIII:C, fibrinogen, D-dimer (a fibrinolytic
product), beta-thromboglobulin, and platelet factor 4; a significantly
higher fibrinogen/antithrombin ratio; and significantly higher spontaneous
amidolytic activity than the healthy controls. Prekallikrein levels were
significantly lower in both groups with nonvalvular atrial fibrillation.
Stroke patients with sinus rhythm had normal hemostatic function, normal
concentrations of platelet-related factors, and a slightly increased
concentration of fibrinopeptide A compared with the healthy controls. Both
groups with nonvalvular atrial fibrillation differed from the stroke
patients with sinus rhythm as they did from the healthy controls. No
difference in hemostatic function was seen between the nonvalvular atrial
fibrillation patients with and without a previous ischemic stroke. Thus,
alterations in hemostatic function may contribute to the increased risk of
stroke in patients with nonvalvular atrial fibrillation.
ARTICLES
Coagulation factors and the increased risk of stroke in nonvalvular atrial fibrillation
Department of Medicine, Danderyd Hospital, Sweden.
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