Abstract 17201: P-selectin Level is Elevated in Patients With Non-valvular Atrial Fibrillation and With Spontaneous Echocardiographic Contrast
Background: The association of P-selectin, a biomarker of platelet activation, with thromboembolic complications in atrial fibrillation remains controversial. We tested the hypothesis that plasma soluble P-selectin (sP-selectin) level correlates with measures of left atrial blood stasis in this dysrhythmia.
Methods: Using a prospective case-control study design, plasma sP-selectin measured by solid-phase ELISA in 109 patients with non-valvular atrial fibrillation (NVAF; age 63±14 years; 26% women) and in 40 controls with normal sinus rhythm (NSR; age 64±14 years; 41% women) who were not on antiplatelet therapy was compared.
Results: The median sP-selectin level was higher in NVAF cases compared to NSR controls [median (IQR) 26 (20-32) ng/ml vs 22 (15-29) ng/ml, p=.005]. While sP-selectin level did not significantly vary by left atrium volume index, left atrial appendage emptying velocity, it was associated with the higher intensity of spontaneous echocardiographic contrast (SEC; p=0.0042, see Figure).
Mean sP-selectin level in NSR Control group, NVAF patients with spontaneous echocardiographic contrast (None, Mild, Moderate, Sever) and NVAF patients with left atrial appendage thrombus (LAAT) sP-selectin was significantly higher amongst patients with severe SEC compared to NSR controls (p<0.0001), to NVAF patients without SEC (p=0.004), with mild SEC (p<0.0001), and moderate SEC (p=0.003). NVAF patients with LAAT had higher sP-selectin compared to NSR controls (p=0.048) but not different compared to other NVAF patients with or without SEC.
Conclusions: Elevated sP-selectin is associated with higher intensity of SEC but not with the presence of LAAT in patients with NVAF.
Author Disclosures: K.P. Cohoon: None. R.D. McBane: None. M. Mazur: None. N.M. Ammash: None. R.M. Melduni: None. S.J. Asirvatham: None. W.E. Wysokinski: None.
- © 2016 by American Heart Association, Inc.