Left Atrial Coagulation Activity in Patient with
Mitral Stenosis in Sinus Rhythm
Songsak Kiatchoosakun MD*,
Chaiyasith Wongvipaporn MD*, Nantarat Komanasin PhD**,
Pyatat Tatsanavivat MD*, Brian D Hoit MD***
Affiliation :
* Division of Cardiology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
** Department of Clinical Microscopy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
*** Division of Cardiology, University Hospitals Case Medical Center,
Harrington-McLaughlin Heart Vascular Institute, Cleveland, OH, USA
Objective : Anticoagulation therapy is strongly recommended in all patients with mitral stenosis (MS) in atrial fibrillation
(AF) but this treatment is controversial in patients in sinus rhythm (SR). The objective of the present study was to investigate
the coagulation activity in patients with MS in sinus rhythm compared to those in atrial fibrillation.
Material and Method: The authors studied the levels of biochemical markers of thrombin generation (thrombin-anti-thrombin
[TAT] complex, fibrinogen, and factor XIII) and fibrinolysis (D-dimer) in specimens of blood from the atria in 35 consecutive
patients with moderate to severe MS (18 in sinus rhythm and 17 in AF) who underwent percutaneous balloon mitral valvotomy.
Results : The levels coagulation factors in left atrium in patients with MS in SR and AF were thrombin-anti-thrombin
complex = 77.218.87 mg/L vs. 73.487.78 mg/L, p = 0.755, fibrinogen = 356.5741.86 mg/L vs. 271.6222.47 mg/L,
p = 0.089, factor XIII = 139.888.96 mg/L vs. 123.426.24 mg/L, p = 0.152, and D-dimer = 846.14137.84 mg/L
vs. 693.88164.67 mg/L, p = 0.481. Levels of coagulation activities did not correlate with the left atrial size.
Conclusion : This present study demonstrates that coagulation activity is not different whether they are in SR or in AF and
suggests that anticoagulation therapy should be considered in these patients.
Keywords : Mitral stenosis, Coagulation activity, Sinus rhythm
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