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Monocyte–platelet aggregates and CD11b expression as markers for thrombogenicity in atrial fibrillation

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Abstract

Background

A strong interdependence is known between atrial fibrillation (AF), inflammation and thrombogenesis. Monocyte–platelet aggregates (MPAs) are sensitive markers of platelets and monocyte activation. It is not known whether MPAs are associated with thrombogenicity in AF. Therefore, we examined differences in the content of MPAs and CD11b expression in patients with AF in dependence of the presence of atrial thrombus formation.

Methods

107 patients with symptomatic AF underwent transesophageal echocardiography (TEE) before planned cardioversion or pulmonary vein isolation. Flow-cytometric quantification analysis was done on the day of performed TEE to determine the content of MPAs and the expression of CD11b on monocytes and granulocytes.

Results

Compared to patients without thrombus (n = 80) those with an echocardiographic proven left atrium (LA) thrombus (n = 27) showed an increased extent of the risk factors age, diabetes and heart failure. The content of MPAs (147 ± 12 vs. 311 ± 29 cells/µl, p < 0.001) as well as the CD11b expression on monocytes (p < 0.05) and granulocytes (p < 0.05) were strongly associated with the existence of a LA thrombus. The content of MPAs and the CD11b expression remained independent predictors for LA thrombus after adjustment in logistic regression analysis and negatively correlated with left atrial appendage flow velocity. MPAs above 170 cells/µl (OR 34.2, p = 0.01) had a sensitivity of 96 % and a specificity of 73 % for predicting LA-thrombus.

Conclusions

The content of MPAs and the CD11b expression on monocytes and granulocytes are increased in AF-patients with proven thrombus formation. They seem to be appropriate biomarkers for stratification of thromboembolic risk in patients with AF.

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Acknowledgments

C.P. was supported by the Deutsche Herzstiftung (Wilhelm P. Winterstein Award). The authors want to thank Peggy Barthel and Lydia Schwab for excellent technical assistance with flow cytometry analysis.

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Authors and Affiliations

  1. Technische Universität Dresden, Heart Center Dresden, University Hospital, Fetscherstrasse 76, 01307, Dresden, Germany

    Christian Pfluecke, Daniel Tarnowski, Lina Plichta, Katharina Berndt, Paul Schumacher, Stefan Ulbrich, Mathias Forkmann, Marian Christoph, David M. Poitz, Carsten Wunderlich, Ruth H. Strasser & Karim Ibrahim

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  1. Christian Pfluecke
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  2. Daniel Tarnowski
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Correspondence to Christian Pfluecke.

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Pfluecke, C., Tarnowski, D., Plichta, L. et al. Monocyte–platelet aggregates and CD11b expression as markers for thrombogenicity in atrial fibrillation. Clin Res Cardiol 105, 314–322 (2016). https://doi.org/10.1007/s00392-015-0922-4

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