• 1. Reef VB, Reimer JM, Spencer PA. Treatment of atrial fibrillation in horses: new perspectives. J Vet Intern Med 1995; 9: 5767.

  • 2. Wyndham CR. Atrial fibrillation: the most common arrhythmia. Tex Heart Inst J 2000; 27: 257267.

  • 3. Kahn SR, Solymoss S, Flegel KM. Nonvalvular atrial fibrillation: evidence for a prothrombotic state. CMAJ 1997; 157: 673681.

  • 4. Lip GY. Stroke in atrial fibrillation: epidemiology and thromboprophylaxis. J Thromb Haemost 2011; 9 (suppl 1): 344351.

  • 5. Lip GY. Can we predict stroke in atrial fibrillation? Clin Cardiol 2012; 35 (suppl 1): 2127.

  • 6. Lip GY, Rumley A, Dunn FG, et al. Plasma fibrinogen and fibrin D-dimer in patients with atrial fibrillation: effects of cardioversion to sinus rhythm. Int J Cardiol 1995; 51: 245251.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7. Watson T, Shantsila E, Lip GY. Mechanisms of thrombogenesis in atrial fibrillation: Virchow's triad revisited. Lancet 2009; 373: 155166.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8. Sadanaga T, Kohsaka S, Ogawa S. D-dimer levels in combination with clinical risk factors can effectively predict subsequent thromboembolic events in patients with atrial fibrillation during oral anticoagulant therapy. Cardiology 2010; 117: 3136.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9. Wysokinski WE, Ammash N, Sobande F, et al. Predicting left atrial thrombi in atrial fibrillation. Am Heart J 2010; 159: 665671.

  • 10. Oltrona L, Broccolino M, Merlini PA, et al. Activation of the hemostatic mechanism after pharmacological cardioversion of acute nonvalvular atrial fibrillation. Circulation 1997; 95: 20032006.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11. Jacob K, Talwar S, Copplestone A, et al. Activation of coagulation occurs after electrical cardioversion in patients with chronic atrial fibrillation despite optimal anticoagulation with warfarin. Int J Cardiol 2004; 95: 8388.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12. Lip GY, Lowe GD, Rumley A, et al. Increased markers of thrombogenesis in chronic atrial fibrillation: effects of warfarin treatment. Br Heart J 1995; 73: 527533.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13. El Gendi H, Ismail T, Charalampos K, et al. Anticoagulation for cardioversion of atrial fibrillation. Minerva Cardioangiol 2002; 50: 4352.

    • Search Google Scholar
    • Export Citation
  • 14. Hatzinikolaou-Kotsakou E, Kartasis Z, Tziakas D, et al. Atrial fibrillation and hypercoagulability: dependent on clinical factors or/and on genetic alterations? J Thromb Thrombolysis 2003; 16: 155161.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15. Sohara H, Miyahara K. Effect of atrial fibrillation on the fibrinocoagulation system—study in patients with paroxysmal atrial fibrillation. Jpn Circ J 1994; 58: 821826.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16. Li-Saw-Hee FL, Blann AD, Gurney D, et al. Plasma von Willebrand factor, fibrinogen and soluble P-selectin levels in paroxysmal, persistent and permanent atrial fibrillation. Effects of cardioversion and return of left atrial function. Eur Heart J 2001; 22: 17411747.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17. Matsue Y, Suzuki M, Abe M, et al. Endothelial dysfunction in paroxysmal atrial fibrillation as a prothrombotic state. Comparison with permanent/persistent atrial fibrillation. J Atheroscler Thromb 2011; 18: 298304.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18. Nakagawa K, Hirai T, Shinokawa N, et al. Aortic spontaneous echocardiographic contrast and hemostatic markers in patients with nonrheumatic atrial fibrillation. Chest 2002; 121: 500505.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19. Vene N, Mavri A, Kosmelj K, et al. High D-dimer levels predict cardiovascular events in patients with chronic atrial fibrillation during oral anticoagulant therapy. Thromb Haemost 2003; 90: 11631172.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20. Hatzinikolaou-Kotsakou E, Hatseras DI. The potential of D-dimer levels as a useful clinical marker of clotting state after the return of sinus rhythm. Future Cardiol 2006; 2: 5561.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21. Body R, Allie B. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Negative D-dimer may allow safe early cardioversion of atrial fibrillation. Emerg Med J 2007; 24: 432435.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22. Mahé I, Bergmann JF, Chassany O, etal COAGFA Group. A multicentric prospective study in usual care: D-dimer and cardiovascular events in patients with atrial fibrillation. Thromb Res 2012; 129: 693699.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23. Alonso A, Tang W, Agarwal SK, et al. Hemostatic markers are associated with the risk and prognosis of atrial fibrillation: the ARIC study. Int J Cardiol 2012; 155: 217222.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24. Freestone B, Lip GY. The endothelium and atrial fibrillation. The prothrombotic state revisited. Hamostaseologie 2008; 28: 207212.

  • 25. Fukuda Y, Kuroiwa Y, Okumiya K, et al. Hypercoagulability in patients with mitral stenosis—from the viewpoint of the behavior of plasma antithrombin III and alpha 2-plasmin inhibitor. Jpn Circ J 1980; 44: 867874.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26. Roldán V, Marín F, Marco P, et al. Hypofibrinolysis in atrial fibrillation. Am Heart J 1998; 136: 956960.

  • 27. Mahé I, Drouet L, Chassany O, et al. D-dimer: a characteristic of the coagulation state of each patient with chronic atrial fibrillation. Thromb Res 2002; 107: 16.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28. Mahé I, Drouet L, Simoneau G, et al. D-dimer can predict survival in patients with chronic atrial fibrillation. Blood Coagul Fibrinolysis 2004; 15: 413417.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29. Banse H, Holbrook TC, Gilliam L, et al. Right ventricular and saphenous vein thrombi associated with sepsis in a Quarter Horse foal. J Vet Intern Med 2012; 26: 178182.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30. Norman TE, Chaffin MK, Perris EE, et al. Massive pulmonary thromboembolism in six horses. Equine Vet J 2008; 40: 514517.

  • 31. Cotovio M, Monreal L, Navarro M, et al. Detection of fibrin deposits in tissues from horses with severe gastrointestinal disorders. J Vet Intern Med 2007; 21: 308313.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32. Cesarini C, Monreal L, Armengou L, et al. Association of admission plasma D-dimer concentration with diagnosis and outcome in horses with colic. J Vet Intern Med 2010; 24: 14901497.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33. Dunkel B, Chan DL, Boston R, et al. Association between hypercoagulability and decreased survival in horses with ischemic or inflammatory gastrointestinal disease. J Vet Intern Med 2010; 24: 14671474.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34. Böhm-Weigert M, Wissel T, Muth H, et al. Long- and short-term in vitro D-dimer stability measured with INNOVANCE D-dimer. Thromb Haemost 2010; 103: 461465.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 35. Kumagai K, Fukunami M, Ohmori M, et al. Increased intracardiovascular clotting in patients with chronic atrial fibrillation. J Am Coll Cardiol 1990; 16: 377380.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 36. Inoue H, Nozawa T, Okumura K, et al. Prothrombotic activity is increased in patients with nonvalvular atrial fibrillation and risk factors for embolism. Chest 2004; 126: 687692.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 37. Wannamethee SG, Whincup PH, Lennon L, et al. Fibrin D-dimer, tissue-type plasminogen activator, von Willebrand factor, and risk of incident stroke in older men. Stroke 2012; 43: 12061211.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 38. Armengou L, Monreal L, Tarancón I, et al. Plasma D-dimer concentration in sick newborn foals. J Vet Intern Med 2008; 22: 411417.

  • 39. Dolente BA, Wilkins PA, Boston RC. Clinicopathologic evidence of disseminated intravascular coagulation in horses with acute colitis. J Am Vet Med Assoc 2002; 220: 10341038.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 40. Cotovio M, Monreal L, Armengou L, et al. Fibrin deposits and organ failure in newborn foals with severe septicemia. J Vet Intern Med 2008; 22: 14031410.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 41. Pusterla N, Luff JA, Myers CJ, et al. Disseminated intravascular coagulation in a horse with Streptococcus equi subspecies zooepidemicus meningoencephalitis and interstitial pneumonia. J Vet Intern Med 2007; 21: 344347.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 42. Bentz AI, Palmer JE, Dallap BL, et al. Prospective evaluation of coagulation in critically ill neonatal foals. J Vet Intern Med 2009; 23: 161167.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 43. Yeo WM, Osterrieder N, Stokol T. Equine herpesvirus type 1 infection induces procoagulant activity in equine monocytes. Vet Res 2013; 44: 16.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 44. McKeever KH, Hinchcliff KW, Kociba GJ, et al. Changes in coagulation and fibrinolysis in horses during exercise. Am J Vet Res 1990; 51: 13351339.

    • Search Google Scholar
    • Export Citation
  • 45. Furui H, Taniguchi N, Yamauchi K, et al. Effects of treadmill exercise on platelet function, blood coagulability and fibrinolytic activity in patients with atrial fibrillation. Jpn Heart J 1987; 28: 177184.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 46. Goette A, Weber M, Lendeckel U, et al. Effect of physical exercise on platelet activity and the von-Willebrand-factor in patients with persistent lone atrial fibrillation. J Interv Card Electrophysiol 2004; 10: 139146.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 47. Dallap Schaer BL, Epstein K. Coagulopathy of the critically ill equine patient. J Vet Emerg Crit Care (San Antonio) 2009; 19: 5365.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 48. Lowe GD. Can haematological tests predict cardiovascular risk? The 2005 Kettle lecture. Br J Haematol 2006; 133: 232250.

  • 49. Hughes M, Lip GY, Guideline Development Group, National Clinical Guideline for Management of Atrial Fibrillation in Primary and Secondary Care, National Institute for Health and Clinical Excellence. Stroke and thromboembolism in atrial fibrillation: a systematic review of stroke risk factors, risk stratification schema and cost effectiveness data. Thromb Haemost 2008; 99: 295304.

    • Search Google Scholar
    • Export Citation
  • 50. Singer DE, Albers GW, Dalen JE, et al. Antithrombotic therapy in atrial fibrillation: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edition). Chest 2008; 133: 546S592S.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 51. Rizos T, Wagner A, Jenetzky E, et al. Paroxysmal atrial fibrillation is more prevalent than persistent atrial fibrillation in acute stroke and transient ischemic attack patients. Cerebrovasc Dis 2011; 32: 276282.

    • Crossref
    • Search Google Scholar
    • Export Citation

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Evaluation of coagulation and fibrinolysis in horses with atrial fibrillation

Cristobal Navas de SolísNew Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA 19348.
Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain.

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Virginia B. ReefNew Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA 19348.

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JoAnn SlackNew Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA 19348.

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Eduard Jose-CunillerasDepartament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain.

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Abstract

OBJECTIVE To evaluate horses with atrial fibrillation for hypercoagulability; plasma D-dimer concentrations, as a marker of a procoagulant state; and a relationship between coagulation profile results and duration of atrial fibrillation or presence of structural heart disease.

DESIGN Case-control study.

ANIMALS Plasma samples from 42 horses (25 with atrial fibrillation and 17 without cardiovascular or systemic disease [control group]).

PROCEDURES Results of hematologic tests (ie, plasma fibrinogen and D-dimer concentrations, prothrombin and activated partial thromboplastin times, and antithrombin activity) in horses were recorded to assess coagulation and fibrinolysis. Historical and clinical variables, as associated with a hypercoagulable state in other species, were also recorded.

RESULTS Horses with atrial fibrillation and control horses lacked clinical signs of hypercoagulation or thromboembolism. Compared with control horses, horses with atrial fibrillation had significantly lower antithrombin activity. No significant differences in plasma fibrinogen and D-dimer concentrations and prothrombin and activated partial thromboplastin times existed between horse groups. In horses with atrial fibrillation versus control horses, a significantly larger proportion had an abnormal plasma D-dimer concentration (10/25 vs 2/17), test results indicative of subclinical activated coagulation (18/25 vs 6/17), or abnormal coagulation test results (25/121 vs 7/85), respectively.

CONCLUSIONS AND CLINICAL RELEVANCE Horses with atrial fibrillation did not have clinical evidence of a hypercoagulable state, but a higher proportion of horses with atrial fibrillation, compared with control horses, did have subclinical activated coagulation on the basis of standard coagulation test results.

Abstract

OBJECTIVE To evaluate horses with atrial fibrillation for hypercoagulability; plasma D-dimer concentrations, as a marker of a procoagulant state; and a relationship between coagulation profile results and duration of atrial fibrillation or presence of structural heart disease.

DESIGN Case-control study.

ANIMALS Plasma samples from 42 horses (25 with atrial fibrillation and 17 without cardiovascular or systemic disease [control group]).

PROCEDURES Results of hematologic tests (ie, plasma fibrinogen and D-dimer concentrations, prothrombin and activated partial thromboplastin times, and antithrombin activity) in horses were recorded to assess coagulation and fibrinolysis. Historical and clinical variables, as associated with a hypercoagulable state in other species, were also recorded.

RESULTS Horses with atrial fibrillation and control horses lacked clinical signs of hypercoagulation or thromboembolism. Compared with control horses, horses with atrial fibrillation had significantly lower antithrombin activity. No significant differences in plasma fibrinogen and D-dimer concentrations and prothrombin and activated partial thromboplastin times existed between horse groups. In horses with atrial fibrillation versus control horses, a significantly larger proportion had an abnormal plasma D-dimer concentration (10/25 vs 2/17), test results indicative of subclinical activated coagulation (18/25 vs 6/17), or abnormal coagulation test results (25/121 vs 7/85), respectively.

CONCLUSIONS AND CLINICAL RELEVANCE Horses with atrial fibrillation did not have clinical evidence of a hypercoagulable state, but a higher proportion of horses with atrial fibrillation, compared with control horses, did have subclinical activated coagulation on the basis of standard coagulation test results.

Contributor Notes

Dr. Navas de Solís’ present address is Texas Veterinary Medical Center, College of Veterinary and Biomedical Sciences, Texas A&M University, College Station TX 77843.

Address correspondence to Dr. Navas de Solís (crisnavasdes@gmail.com).