Effects of anticoagulant therapy on alteration of fibrinolysis parameters in patients with nonvalvular atrial fibrillation

Objective:To explore the role of fibrinolysis system in the formation of hypercoagulable state with nonvalvular atrial fibrillation(NVAF) patients and investigate the variation tendency of PAI-1 and D-dimer levels along with the anticoagulant therapy.Method:Patients were divided into NVAF group(n=25) and control group(sinus rhythm with age-matched hypertensive patients,n=27).ELISA method was used to detect the plasma levels of PAI-1and D-dimer.The difference of PAI-1,D-dimer levels in two groups,the variation tendency of the two indexes along with anticoagulant therapy,and the correlation among PAI-1,D-dimer and INR were analyzed.Result:①The levels of PAI-1and D-dimer in NVAF group were higher than those in control group(both P 0.05).②The plasma levels of PAI-1and D-dimer significant changed at each time points(the 1st day,7th day,1st month,2nd month)(all P0.05).The decreased percentage of PAI-1concentration were 7%,18% and 31%,respectively;while D-dimer were 19%,34% and 43%.③The variations of PAI-1level at 1st month and 2nd month were different between control group and NVAF group(both P0.05),the variations of D-dimer level at 7th day and 1st month were different between control group and NV AF group(both P0.05).④PAI-1and D-dimer levels were higher in INR≤2.0group than those in INR2.0group.PAI-1,D-dimer and INR levels were negatively correlated(r were-0.263,-0.443;P were 0.010,0.000,respectively),while PAI-1and Ddimer were positively correlated(r=0.468,P=0.000).Conclusion:Low fibrinolysis state is an important factor in the formation of hypercoagulable state in NVAF.Anticoagulant therapy can improve the fibrinolysis state in NVAF patients quickly and effectively.