Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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Advances in Clinical and Experimental Medicine

2019, vol. 28, nr 11, November, p. 1451–1457

doi: 10.17219/acem/104557

Publication type: original article

Language: English

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CHA2DS2-VASc score and fibrinogen concentration in patients with atrial fibrillation

Karolina Semczuk-Kaczmarek1,A,B,C,D,E,F, Anna E. Płatek1,2,A,B,C,D,E,F, Anna Ryś1,A,B,C,D,E,F, Jakub Adamowicz3,4,A,B,C,D,E,F, Paweł Legosz5,A,B,C,D,E,F, Marcin Kotkowski6,A,B,C,D,E,F, Alicja Dudzik-Płocica1,A,B,C,D,E,F, Dariusz Gorko2,7,A,B,C,D,E,F, Filip M. Szymański1,A,B,C,D,E,F, Krzysztof J. Filipiak1,A,B,C,D,E,F

1 1st Department of Cardiology, Medical University of Warsaw, Poland

2 Department of General and Experimental Pathology with Centre for Preclinical Research and Technology (CEPT), Medical University of Warsaw, Poland

3 Department of Clinical Nursing, Wroclaw Medical University, Poland

4 Department of Cardiology, T. Marciniak Lower Silesian Specialist Hospital, Wrocław, Poland

5 Department of Orthopedics and Traumatology of the Musculoskeletal System, Medical University of Warsaw, Poland

6 Department of Neuroradiology, Institute of Psychiatry and Neurology, Warszawa, Poland

7 Cardiology Department, Regional Hospital in Kołobrzeg, Poland

Abstract

Background. Assessment of thromboembolic risk is crucial in choosing appropriate treatment in atrial fibrillation (AF). Current guidelines recommend basing the decision on the CHA2DS2-VASc score. However, the score is based only on clinical parameters and therefore its relationship with laboratory-assessed coagulation status might not always be objective.
Objectives. The aim of this study was to assess if the CHA2DS2-VASc score is associated with blood parameters in AF patients.
Material and Methods. Patients with continuous AF prequalified for catheter ablation were enrolled into the study and had CHA2DS2-VASc calculated and blood taken for coagulation parameters.
Results. The study population comprised of 266 patients (65.0% males; age 57.6 ±10.1 years). Patients were divided into those with CHA2DS2-VASc score 0, and those with ≥1 points, respectively requiring and not requiring anticoagulation treatment. The group with CHA2DS2-VASc = 0 (12% of patients) compared to those with CHA2DS2-VASc ≥ 1 had a significantly lower fibrinogen concentration (285.6 ±82.0 vs 322.6 ±76.4 mg/dL; p = 0.02). Partial thromboplastin time was not significantly different between groups (p > 0.05). Differences were noticed in parameters concerning red blood cells. Lower risk patients had a lower red blood cell count (4.9 ±0.4 vs 5.1 ±6.0 106/μL); p = 0.03), higher hemoglobin concentration (14.9 ±1.0 vs 14.3 ±1.4 g/dL; p = 0.04), and higher hematocrit (43.5 ±2.6 vs 41.7 ±4.7%; p = 0.001). It was observed that along with the increase in CHA2DS2-VASc score mean fibrinogen concentration increased (p-value for trend = 0.04).
Conclusion. In summary, a higher CHA2DS2-VASc score is independently associated with an increase in fibrinogen concentration. Further research is needed to assess the value of fibrinogen in thromboembolic risk assessment.

Key words

fibrinogen, atrial fibrillation, thromboembolic risk, CHA2DS2-VASc score

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