Effect of anticoagulant therapy on arterial stiffness parameters in relation to endothelial dysfunction characteristic values in patients with atrial fibrillation (results of the ALICE study)

• Zolotovskaia Irina A.
• Duplyakov Dmitriy V.
• Davydkin Igor L.
• Romanchuk N.P.

Abstract

The aim of the study was to investigate effect of anticoagulant therapy on arterial stiffness parameters in relation to endothelial dysfunction characteristic values in patients with atrial fibrillation (acronym ALICE).

Material and methods. 130 patients with paroxysmal or persistent form of atrialfibrillation were included in the trial (55 men, mean age 71.2 ± 5.9 years). All of them underwent cardioembolic stroke and were discharged from primary vascular centers with recommendations for anticoagulant therapy who had not taken anticoagulants previously. Patients were randomized into two groups. In the first group (n=65) at the time of inclusion patients were taking new oral anticoagulants (NPOAC) after stroke, in the second group (n=65) patients have made denial letter to receive NPOAC for any reason. On the first visit (V₁) and after 6 months (V₂) markers of endothelial dysfunction (ED) were determined and parameters of arterial stiffness were assessed using volumetric sphygmoplethysmography on «VaSera-1000» apparatus.

Results. At the beginning of the study, patients of both groups were comparable in all parameters of volumetric sphygmoplethysmography. Iimprovement of R-PWV, L-PWV, AI-R, and CAVI parameters was noted in group of patients who were taking NPOAC, and significant correlation was found between CAVI and following ED characteristic values: FW, % (r=0.61, p=0.003); plasminogen,% (r=-0.59, p=0.0038); PAI1, ng/ml (r=0.52, p=0.002); PA III,%(r=-0.49, p=0.018).

Conclusion. According to the ALISA study, there was a significant improvement in arterial stiffness and a decrease of ED severity in case of AF and NPOAC intake for 24 weeks, which suggests that there are additional positive effects in this product group.

Keywords:anticoagulant therapy, arterial stiffness, endothelial dysfunction, atrial fibrillation, cardioembolic stroke

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