NDLI: Urinary 11-dehydro-thromboxane B2 is associated with cardiovascular events and mortality in atrial fibrillation patients

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Urinary 11-dehydro-thromboxane B2 is associated with cardiovascular events and mortality in atrial fibrillation patients

Content Provider	Semantic Scholar
Author	Pastori, Daniele Pignatelli, Pasquale Farcomeni, Alessio Cangemi, Roberto Hiat, William R. Bartimoccia, Simona Nocella, Cristina Vicario, Tommasa Bucci, Tommaso Carnevale, Roberto Lip, Gregory Y. H. Violi, Francesco
Copyright Year	2015
Abstract	BACKGROUND: Non-Valvular Atrial Fibrillation (AF) patients show high residual cardiovascular risk despite oral anticoagulants. Urinary 11-dehydro-thromboxane B2 (TxB2) is associated with an increased risk of cardiovascular events (CVEs), but its predictive value in anticoagulated AF patients is unknown. METHODS: Prospective single-center cohort study, including 837 AF patients. Mean time of followup was 30.0 months yielding 2062 person-years of observation. Urinary 11-dehydro-TxB2 was measured at baseline. The primary end-point was the occurrence of a CVE including fatal/nonfatal myocardial infarction (MI) and ischemic stroke, transient ischemic atack, cardiac revascularization and cardiovascular death. RESULTS: Mean age of patients was 73.1 years, and 43.6% were women. Median 11-dehydro-TxB2 levels were 100 [IQR 50 -187] ng/mg of urinary creatinine. Overall, the anticoagulation control was adequate (63.9% of mean time in therapeutic range). A CVE occurred in 99 (11.8%) patients, 55 were CV deaths. At baseline, 11-dehydro-TxB2 levels were higher in patients with a CVE compared to those without (186 [107-400] vs. 98 [52-170], p<0.001). An increased rate of CVEs (Log-Rank test, p<0.001) and CV deaths (p<0.001) was observed across tertiles of 11-dehydro-TxB2. CVEs were associated with age (Hazard Ratios [HR]: 1.72 per 1SD, 95% Confidence Interval [CI] 1.33 -2.21, p<0.001), diabetes mellitus (HR: 1.89 95%CI 1.20-2.96, p=0.005), heart failure (HR: 1.60, 95%CI 1.01-2.54, p=0.044), history of stroke/transient ischemic attack (HR: 1.96, 95%CI 1.25-3.06, p=0.003) and 11-dehydro-TxB2 (HR: 1.64 per 1 SD, 95%CI 1.42-1.89, p<0.001). CONCLUSIONS: Urinary 11-dehydro-TxB2 levels are associated with a residual risk of CVEs and CV mortality in AF patients despite anticoagulant treatment.
File Format	PDF HTM / HTML
Alternate Webpage(s)	http://www.afarcome.altervista.org/thromboxane.pdf
Language	English
Access Restriction	Open
Content Type	Text
Resource Type	Article

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