Alterations of hemostatic markers in elderly patient with atrial fibrillation without a history of stroke

Abstract

To evaluate whether hemostatic abnormalities contribute to the increased risk of stroke, the authors prospectively studied the hemostatic markers (HM) (beta-TG, PF4, FPA, TAT, PIC, D-dimer) in 34 elderly patients with atrial fibrillation (Af) without a history of stroke (mean age 79.2) and 14 age-matched controls. In the Af group FPA was significantly higher than in the control group (p < 0.05). Among them, 8 patients showed a similar abnormal HM pattern as in cardioembolic is chemic stroke and in these, 4/8 patients had valvular disease (VD), 2/8 had hypertension (HT), 2/8 had congestive heart failure (CHF), 1/8 had diabetes mellitus (DM) and 1/8 had hyperlipidemia (HL). Eight patients showed the same abnormal HM pattern as atherothrombotic is chemic stroke and of these, 2/8 had HT as complications. Five patients showed combination of a HM abnormal pattern, that was observed in cardioembolic and atherothromboic ischemic stroke. The other 13 patients showed a normal HM pattern, were in these patients, 4/13 had HT, 1/13 had DM, 1/13 had VD, and 1/13 had CHF. The patients with VD complication tended to have embolic HM abnormality. Contrary to previous reports, nonvalvular Af patients do not necessarily tend to have high risk of cardioembolic stroke. Our data suggest difficulties in clinical diagnosis among Af patients with ischemic stroke whether it is cardio embolic or atherothrombotic.