Clinical and biochemical aspects of coagulation control in patients with atrial fibrillation and excessive alcohol consumption

Aim. Reveal the influence of excessive alcohol consumption on blood coagulation system, levels of blood proteins in patients with atrial fibrillation treated with warfarin.

Methods. The study included 80 patients with a diagnosis of atrial fibrillation, treated with vitamin K antagonists. The study group included 34 patients with excessive alcohol consumption (according to the questionnaire), the comparison group - 46 patients with no excessive alcohol consumption. Transferrin, hemopexin, aspartate transaminase, alanine transaminase, gamma-glutamyl transferase, carbohydrate-deficient transferrin levels were measured in venous blood serum, serum protein electrophoresis was performed. Parameters of plasma hemostasis tests and D-dimer level were also analyzed.

Results. Gamma-glutamyl transferase activity in patients of study group was 1.5 times higher compared to the comparison group (p=0.021). There was no statically significant differences in aspartate transaminase and alanine transaminase activity, but their levels were increased in alcohol abusers with gamma-glutamyl transferase above normal values (55 U/l). None of the patients had increased level of carbohydrate-deficient transferrin. Absolute and relative serum β1-globulin concentrations were significantly reduced in study group patients, while hemopexin and transferrin levels were at the same level as in the control group. No differences of coagulation parameters were between the groups. In the study group, in patients with β1-globulin levels below the median values, international normalized ratio was significantly closer to the target values, but the same patients had higher D-dimer levels, which apparently indicates low effect of anticoagulants.

Conclusion. The effect of anticoagulant was low in patients with excessive alcohol consumption and atrial fibrillation, as evidenced by elevated D-dimer levels at international normalized ratio close to the target values. Patients with atrial fibrillation and excessive alcohol consumption with elevated D-dimer levels had serum β1-globulin levels reduced compared to median values.