Abstract 18214: Aggressive Risk Factor Management Reduces Platelet Activation and Improves Endothelial Function in Patients With AF: Implications for Stroke Reduction
Objective: Presence of cardiac risk factors increases risk of thromboembolism in atrial fibrillation (AF). We sought to assess the effect of aggressive risk factor management on atrial thrombogenesis by determining the impact on platelet activation and endothelial function.
Methods: 50 consecutive symptomatic AF patients with BMI ≥ 27 kg/m2 and ≥1 cardiac risk factor were randomised to either weight and RF management (RFM) or usual care (Control). The RFM group were managed in a physician-led multidisciplinary clinic directed at RF control in accordance with AHA/ACC guidelines. Blood samples were taken from cubital fossa vein at baseline and at >6 months post initial study. In RFM group it was after ≥10% WL and ≥6 months of optimal RF management.
Results: There were no differences in baseline characteristics or follow up duration (15.7 ± 3.4 mths) between the groups (p=NS). RFM resulted in greater reduction in weight (p<0.001), systolic blood pressure (p=0.004), better glycaemic control (p=0.003) and lipid profile (p=0.04). The mean number of AF episodes and total AF burden was similar in both the groups at baseline (P>0.05). At final follow-up, both number of episodes (P=0.001) and total AF burden (P<0.001) decreased in RFM and did not change significantly in controls. The Table presents the data showing that RFM resulted in marked improvement in endothelial function, decreased platelet activation and reduced inflammatory state.
Conclusion: Aggressive risk factor management is associated with an improvement in endothelial and platelet function along with reduced inflammatory state. These findings may demonstrate the potential mechanism to reduce risk of thromboembolism in patients with AF. (Trial registration: ACTRN12613000444785)
Author Disclosures: R.K. Pathak: None. S. Willoughby: None. D.H. Lau: None. P. Sanders: Research Grant; Modest; Sorin. Speakers Bureau; Modest; Biosense- Webster, Medtronic, St Jude Medical, Boston Scientific. Consultant/Advisory Board; Modest; Biosense-Webster, Medtronic, St Jude Medical, Boston Scientific, CathRx. Research Grant; Significant; Boston Scientific, St Jude Medical, Medtronic, Biotronik.
- © 2016 by American Heart Association, Inc.