[The system of hemostasis in patients with atrial fibrillation: markers of left auricular thrombosis].

Thrombosis of the left atrial appendage (LAA) is considered to be main cause of thromboembolic complications of atrial fibrillation (AF). Aim of this work was to study parameters of the hemostasis system in patients with AF in dependence on the presence of thrombus in the LAA. We examined 92 patients (58 men and 34 women) who at hospital admission had AF attack which lasted more than 48 hours. In patients with thrombus in the LAA according to data of transesophageal echocardiography differed magnitude of mean pulmonary artery pressure (odds ratio [OR] 1.053 95% confidence interval [CI] 1.007 to 1.102, p=0.024), diameter of left ventricular (LV) outflow tract (OR 7.711 95% CI 1.291 to 46.029, p=0.025), LV ejection fraction less than 40% (OR 0.286 95% CI 0.081 to 1.008, p=0.051), levels of type 1 plasminogen activator inhibitor-PAI-1 (OR 0.641 95% CI 0.422 to 0.974, p=0.037), and D-dimer (OR 1.003, 95% CI 1.000 to 1.006, p=0.046). Factors independently related to the presence of thrombus in LAA turned out only levels of PAI-1 (OR 0.51, 95% CI 0.276 to 0.936, p=0.03) and D-dimer (OR 1.01, 95% CI 1.001 to 1.014, p=0.026). Thus depletion of the system of fibrinolysis can lead to thrombus formation in the LAA and increase risk of development of thromboembolic complications.