Correlations of C-reactive protein, von Willebrand factor, and carotid artery intima-media thickness with CHA2DS2-VASc in patients with acute atrial fibrillation

Introduction The risk of stroke in patients with atrial fibrillation (AF) seems to be independent of the

presence or duration of arrhythmia at a given moment. However, there is no single approved measurable

parameter that would allow to predict the risk of stroke in patients with newly diagnosed AF.

Objectives We aimed to determine the levels of von Willebrand factor (vWF) and high-sensitivity

C-reactive protein (hs-CRP) as well as to measure the intima-media thickness (IMT) in patients in the

first hours of an AF episode and compare these markers with predicted risk of stroke.

Patient s and methods The study group consisted of 60 consecutive adult patients with symptomatic

AF lasting less than 48 hours. In all patients, vWF and hs-CRP levels as well as IMT were measured and

compared with the calculated CHA2DS2-VASc score.

Result s We found a significant difference in the levels of the measured markers (vWF, 110.3% [range,

92.3%–124.2%] vs 170.2% [range, 111.1%–219.5%], P <0.005; hs-CRP, 1.08 mg/l [range, 0.46–2.49

mg/l] vs 3.43 mg/l [range, 1.59; 5.95 mg/l]; P <0.005) and IMT (0.62 mm [range, 0.56–0.71 mm] vs

0.75 mm [range, 0.63–0.81 mm], P = 0.01) between patients with a CHA2DS2-VASc score of less than 2

and those with a score of 2 or higher. Using the receiver operating characteristic curves, we determined

the optimal cut-off points for hs-CRP (1.27 mg/l), vWF (153.25%), and IMT (0.65 mm), which allowed

us to identify patients requiring oral anticoagulation.

Conclusions The tested parameters allow, with moderate sensitivity and specificity, to predict the

presence of indications for chronic oral antithrombotic prophylaxis in patients with newly diagnosed

AF. In order to determine the real ability of these parameters to predict stroke, a prospective long-term

follow-up is required.

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