Serum heparanase levels and left atrial/left atrial appendage thrombus in patients with nonvalvular atrial fibrillation,Herz

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Serum heparanase levels and left atrial/left atrial appendage thrombus in patients with nonvalvular atrial fibrillation
Herz ( IF 1.7 ) Pub Date : 2021-08-05 , DOI: 10.1007/s00059-021-05052-z
Mehmet Fatih Yilmaz ₁ , Emrah Acar ₂ , Mehmet Inanir ₃ , Can Yücel Karabay ₁ , Ibrahim Akin Izgi ₄

Affiliation

Introduction

Data regarding the possible role of heparanase (HPA) in the occurrence of left atrial/left atrial appendage (LA/LAA) thrombus in patients with atrial fibrillation (AF) is lacking. The goal of the present study was to assess the association between plasma levels of HPA and LA/LAA thrombus in AF.

Methods

A total of 687 patients with nonvalvular AF (NVAF) without anticoagulation therapy were included from January 2016 to June 2019. Serum HPA analysis was performed with a commercially available human ELISA kit. Logistic regression models were used to test for association.

Results

Serum HPA levels were significantly higher in patients with LA/LAA thrombus than in those without LA/LAA thrombus (270.8 [193.4 ± 353.2] pg/mL vs 150.3 [125.2 ± 208.4] pg/mL; P < 0.001). In multivariate analysis, serum HPA remained a significantly independent predictor of LA/LAA thrombus (odds ratio 1.674, 95% confidence interval [CI] 1.339–2.289, P < 0.001). In the receiver operating characteristic (ROC) curve analysis, HPA showed a predictive value with an area under the curve (AUC) of 0.757 (95% CI 0.652–0.810, P < 0.001). The optimal cutoff level for HPA predicting LA/LAA thrombus was 210.7 pg/mL, with a sensitivity of 74.3% and a specificity of 64.8%.

Conclusion

An elevated HPA level was associated with the presence of LA/LAA thrombus in patients with AF. HPA might portend the risk for the prothrombotic state in AF patients.

中文翻译：

非瓣膜性心房颤动患者的血清乙酰肝素酶水平和左心房/左心耳血栓

介绍

缺乏关于乙酰肝素酶 (HPA) 在心房颤动 (AF) 患者发生左心房/左心耳 (LA/LAA) 血栓中可能作用的数据。本研究的目的是评估 AF 中 HPA 血浆水平与 LA/LAA 血栓之间的关联。

方法

从 2016 年 1 月至 2019 年 6 月，共纳入 687 名未接受抗凝治疗的非瓣膜性房颤 (NVAF) 患者。血清 HPA 分析使用市售的人类 ELISA 试剂盒进行。逻辑回归模型用于测试关联。

结果

LA/LAA 血栓患者的血清 HPA 水平显着高于没有 LA/LAA 血栓的患者（270.8 [193.4 ± 353.2] pg/mL vs 150.3 [125.2 ± 208.4] pg/mL；P  < 0.001）。在多变量分析中，血清 HPA 仍然是 LA/LAA 血栓的显着独立预测因子（优势比 1.674，95% 置信区间 [CI] 1.339-2.289，P  < 0.001）。在接受者操作特征 (ROC) 曲线分析中，HPA 显示出预测值，曲线下面积 (AUC) 为 0.757 (95% CI 0.652–0.810, P  < 0.001)。HPA 预测 LA/LAA 血栓的最佳截止水平为 210.7 pg/mL，敏感性为 74.3%，特异性为 64.8%。