Introduction: The risk of stroke in patients with atrial fibrillation (AF) seems to be independent of the presence or duration of arrhythmia at a given moment. However, there is no single approved measurable parameter that would allow to predict the risk of stroke in patients with newly diagnosed AF.
Objectives: We aimed to determine the levels of von Willebrand factor (vWF) and high-sensitivity C-reactive protein (hs-CRP) as well as to measure the intima-media thickness (IMT) in patients in the first hours of an AF episode and compare these markers with predicted risk of stroke.
Patients and methods: The study group consisted of 60 consecutive adult patients with symptomatic AF lasting less than 48 hours. In all patients, vWF and hs-CRP levels as well as IMT were measured and compared with the calculated CHA2DS2-VASc score.
Results: We found a significant difference in the levels of the measured markers (vWF, 110.3% [range, 92.3%-124.2%] vs 170.2% [range, 111.1%-219.5%], P <0.005; hs-CRP, 1.08 mg/l [range, 0.46-2.49 mg/l] vs 3.43 mg/l [range, 1.59; 5.95 mg/l]; P <0.005) and IMT (0.62 mm [range, 0.56-0.71 mm] vs 0.75 mm [range, 0.63-0.81 mm], P = 0.01) between patients with a CHA2DS2-VASc score of less than 2 and those with a score of 2 or higher. Using the receiver operating characteristic curves, we determined the optimal cut-off points for hs-CRP (1.27 mg/l), vWF (153.25%), and IMT (0.65 mm), which allowed us to identify patients requiring oral anticoagulation.
Conclusions: The tested parameters allow, with moderate sensitivity and specificity, to predict the presence of indications for chronic oral antithrombotic prophylaxis in patients with newly diagnosed AF. In order to determine the real ability of these parameters to predict stroke, a prospective long-term follow-up is required.