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001-es BibID:	bibEBI00026273
035-os BibID:	(cikkazonosító)E3050 (WoS)000581708900001 (Scopus)85108175368
Első szerző:	Bagoly Zsuzsa (orvos)
Cím:	Uninterrupted Dabigatran Administration Provides Greater Inhibition against Intracardiac Activation of Hemostasis as Compared to Vitamin K Antagonists during Cryoballoon Catheter Ablation of Atrial Fibrillation / Zsuzsa Bagoly, Orsolya Hajas, Réka Urbancsek, Alexandra Kiss, Edit Fiak, Ferenc Sarkady, Noémi Klára Tóth, Rita Orbán-Kálmándi, Kitti Bernadett Kovács, László Nagy, Attila Nagy, János Kappelmayer, László Csiba, Zoltán Csanádi
Dátum:	2020
ISSN:	2077-0383
Megjegyzések:	Background. Cerebral thromboembolism is a rare but feared complication of transcatheter ablation in patients with atrial fibrillation (AF). Here, we aimed to test which pre-procedural anticoagulation strategy results in less intracardiac activation of hemostasis during ablation. Patients and methods. In this observational study, 54 paroxysmal / persistent AF patients undergoing cryoballoon ablation were grouped according to their periprocedural anticoagulation strategy: no anticoagulation (oral anticoagulation (OAC) free; n = 24), uninterrupted vitamin K antagonists (VKA) ( n = 11), uninterrupted dabigatran ( n = 17). Blood was drawn from the left atrium before and immediately after the ablation procedure. Cryoablations were performed according to standard protocols, during which heparin was administered. Heparin-insensitive markers of hemostasis and endothelial damage were tested from intracardiac samples: D-dimer, quantitative fibrin monomer (FM), plasmin-antiplasmin complex (PAP), von Willebrand factor (VWF) antigen, chromogenic factor VIII (FVIII) activity. Results. D-dimer increased significantly in all groups post-ablation, with lowest levels in the dabigatran group (median [interquartile range]: 0.27 [0.36] vs. 1.09 [1.30] and 0.74 [0.26] mg / L in OAC free and uninterrupted VKA groups, respectively, p < 0.001 ). PAP levels were parallel to this observation. Post-ablation FM levels were elevated in OAC free ( 26.34 [30.04] mg / L ) and VKA groups (10.12 [16.01] mg / L), but remained below cut-o in all patients on dabigatran ( 3.98 [2.0] mg / L; p < 0.001). VWF antigen and FVIII activity increased similarly post-ablation in all groups, suggesting comparable procedure-related endothelial damage. Conclusion. Dabigatran provides greater inhibition against intracardiac activation of hemostasis as compared to VKAs during cryoballoon catheter ablation.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk atrial fibrillation cryoballoon ablation; dabigatran vitamin K antagonists
Megjelenés:	Journal of Clinical Medicine. - 9 : 9 (2020), p. 1-13. -
További szerzők:	Hajas Orsolya (1987-) Urbancsek Réka (1991-) (általános orvos) Kiss Alexandra (1987-) (általános orvos) Fiák Edit Sarkady Ferenc (1982-) (laboratóriumi analitikus) Tóth Noémi Klára Orbán-Kálmándi Rita Angéla (1993-) (klinikai laboratóriumi kutató) Kovács Kitti Bernadett (1985-) (neurológus) Nagy László Tibor (1969-) (belgyógyász, kardiológus) Nagy Attila Csaba (1981-) (megelőző orvostan és népegészségtan szakorvos, epidemiológus) Kappelmayer János (1960-) (laboratóriumi szakorvos) Csiba László (1952-) (neurológus, pszichiáter) Csanádi Zoltán (1960-) (kardiológus)
Pályázati támogatás:	GINOP-2.3.2-15-2016-00043 GINOP MTA-DE MTA K109712 OTKA K120042 OTKA FK128582 OTKA
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