Association Of Adipocytokines Serum Levels With Left Atrial Thrombus Formation In Atrial Fibrillation Patients On Oral Anticoagulation (Alert) – A Cross-Sectional Study

Abstract Background and Aims Oral anticoagulation is effective for stroke prevention in atrial fibrillation (AF). However, strokes may still occur in high-risk individuals. We conducted a prospective trial to assess the association between adipocytokine serum levels and surrogate parameters for thromboembolic events. Methods and Results In this cross-sectional multicenter trial, we enrolled 189 patients with AF who were on oral anticoagulation. The primary endpoint was defined as either the presence of spontaneous echo contrast (SEC), a left atrial appendage (LAA), or a left atrial (LA) thrombus on transesophageal echocardiography. We investigated the association of adipocytokine serum levels with the combined endpoint using logistic regression analysis. Forty-eight individuals (25%) were assigned to group 1 (G1) due to the occurrence of at least one of the components of the combined endpoint (41 [21.7%] SEC, 3 [1.6%] LA thrombus, 13 [6.9%] LAA thrombus), whereas the remaining patients formed group 2 (G2). The BMI, logarithmized (loge) leptin (G1: 2.0±1.3 μg/ml, G2: 2.0±1.1 μg/ml, p=0.746) and visfatin serum levels (G1: 3.4±0.3 ng/ml, G2: 3.4±0.5 ng/ml, p=0.900) did not significantly differ between the groups. Conversely, logarithmized adiponectin (G1: 3.3±0.6 ng/ml, G2: 3.1±0.7 ng/ml, p=0.036) and resistin levels (G1: 1.8±0.5 ng/ml, G2: 1.6±0.5 ng/ml, p=0.009) were higher in patients with the primary endpoint. Multivariate logistic regression analysis using a score that combined the individual adiponectin and resistin values in each patient corroborated this association. Conclusions Our results suggest that adiponectin and resistin may act as potential biomarkers to identify individuals with AF who are at high thromboembolic risk.