Lipoprotein(a), Left Atrial Appendage Function and Thromboembolic Risk in Patients With Chronic Nonvalvular Atrial Fibrillation
スポンサーリンク
概要
- 論文の詳細を見る
Lipoprotein(a) (Lp(a)) has a prothrombotic effect by modulating the fibrinolytic system. The purpose of the present study was to determine whether serum Lp(a) levels are associated with an increased risk of thromboembolism in chronic nonvalvular atrial fibrillation(NVAF). Clinical, laboratory and transesophageal echocardiographic data were collected in 172 consecutive, non-anticoagulated patients with chronic NVAF. Thirty-four patients (thromboembolic group) had a recent (<1 month) embolic event and/or a left atrial thrombus on transesophageal echocardiography. The thromboembolic group had a higher frequency of spontaneous echo contrast (94 vs 58%, p<0.0001), increased concentrations of Lp(a) (median: 31.5 vs 15.5 mg/dl, p<0.0001) and fibrinogen (median: 352 vs 314 mg/dl, p=0.0015), larger left atrial dimensions (median: 5.1 vs 4.8 cm, p=0.0078), and reduced left atrial appendage (LAA) flow velocities (median: 9.5 vs 21.2 cm/s, p<0.0001) than the nonthromboembolic group. Multivariate analysis identified 3 independent predictors of thromboembolism: Lp(a) level ≥30 mg/dl (odds ratio (OR) 9.5, 95% confidence interval (CI) 4.4-20.4, p<0.0001), LAA flow velocity of <20 cm/s (OR 8.7, 95% CI 3.3-23.0, p=0.0003) and a fibrinogen concentration of <377 mg/dl (OR 3.2, 95% CI 1.5-6.9, p=0.0201). The Lp(a) elevations and reduced LAA flow velocities are independently associated with thromboembolism in chronic NVAF.
- 社団法人日本循環器学会の論文
- 2000-01-20
著者
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Aizawa Yoshifusa
the First Department of Internal Medicine
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Kasai Hidehiro
The First Department of Internal Medicine, Niigata University School of Medicine
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Igarashi Yutaka
Division Of Cardiology Department Of Medicine Shonai Municipal Hospital
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Ojima Kenji
Division Of Cardiology Department Of Medicine Shonai Municipal Hospital
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Yamashita Fumio
The First Department of Internal Medicine, Niigata University School of Medicine
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Sato Tadashi
Division of Cardiology, Department of Medicine, Tsuruoka City Shonai Hospital
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Inuzuka Hiroshi
Division of Cardiology, Department of Medicine, Tsuruoka City Shonai Hospital
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Kasai Hidehiro
The First Department Of Internal Medicine Niigata University School Of Medicine
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Aizawa Y
First Department Of Internal Medicine Niigata University Graduate School Of Medical And Dental Scien
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Sato Tadashi
Division Of Cardiology Department Of Medicine Shonai Municipal Hospital
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Kasai Hidehiro
First Department Of Internal Medicine Niigata University School Of Medicine
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Yamashita Fumio
Divisions Of Cardiology Niigata University Graduate School Of Medical And Dental Sciences
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Inuzuka Hiroshi
Division Of Cardiology Department Of Medicine Tsuruoka City Shonai Hospital
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Aizawa Yoshifusa
Cardiovascular Medicine Niigata University Graduate School Of Medicine
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Aizawa Yoshifusa
Division Of Cardiology Niigata University Graduate School Of Medicine And Dental Sciences
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Aizawa Yoshifusa
The First Department Of Internal Madicine Niigata University School Of Medicine
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