Laboratory markers of inflammation and thrombosis in patients with thrombotic and thromboembolic complications and atrial fibrillation

Abstract

Summary. Aim: to evaluate serum markers of inflammation and thrombosis in patients with atrial fibrillation (AF) receiving anticoagulant therapy and having a history of thrombotic (TC) and thromboembolic complications (TEC). Materials and Methods. This single-center, prospective, observational, uncontrolled, non-randomized clinical trial included 38 patients with AF (mean age 65.7 ± 12.5 years, receiving anticoagulant therapy and having a history of TEC), 39 patients with AF (mean age 60.20 ± 1.73 years, with no history of TC or TEC), and 31 healthy volunteers (mean age 31.2 ± 6.1 years, with no history of AF or TC). Biomarkers (α2-macroglobulin, high-sensitivity C-reactive protein, fetuin A, α1-acid glycoprotein, L-selectin, serum amyloid protein, adipsin, and platelet factor 4) were determined using a multiplex assay. Soluble thrombomodulin concentrations were measured using an enzyme-linked immunosorbent assay. Results. Thirty-eight patients were diagnosed with TOC and TEC during anticoagulant therapy prescribed according to current clinical guidelines for AF. Left atrial appendage thrombosis was observed in 25 patients (66%), right atrial thrombosis — in 1 patient (3%), cardioembolic stroke — in 8 patients (21%), peripheral arterial thrombosis — in 1 patient (3%), pacemaker lead thrombosis — in 2 patients (6%), peripheral venous thrombosis — in 3 patients (7%), and pulmonary embolism — in 1 patient (3%). Using binary logistic regression, a prognostic model was constructed showing that an elevated α2-macroglobulin concentration by 1 μg/ml increases TC chance in patients with AF by 3.38-fold (95% confidence interval (CI) = 1.33–8.58), and reduction of L-selectin concentration by 1 μg/ml increases TC chance in patients with AF by 7.58-fold (95% CI = 0.035– 0.500). Conclusion. Low levels of L-selectin and soluble thrombomodulin, along with elevated serum α2-macroglobulin, lead to a shift in the balance of proand anti-inflammatory biomarkers and an increase in prothrombogenic potential in patients with AF.

For citation: Dragunova M.A., Ogurkova O.N., Sitkova E.S., Moskovskikh T.V., Batalov R.E., Suslova T.E. Laboratory markers of inflammation and thrombosis in patients with thrombotic and thromboembolic complications and atrial fibrillation. Tromboz, gemostaz i reologiya. 2026;(2):46–54. (In Russ.).

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