and Purpose-Tissue factor (TF; an initiator of coagulation) and vascular endothelial growth factor (VEGF; a marker of angiogenesis) are involved in the hypercoagulable state associated with malignancy. We investigated their roles in chronic atrial fibrillation (AF), a condition also associated with increased risk of stroke and thromboembolism, as well as a prothrombotic or hypercoagulable state. Methods-We studied 25 patients with AF (20 men; meanϮSD age, 62Ϯ13 years) who were compared with 2

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... ntrol groups in sinus rhythm: 30 healthy control subjects (17 men; mean age, 60Ϯ9 years) and 35 patient control subjects with coronary artery disease (CAD; 27 men; mean age, 60Ϯ12 years). Plasma levels of TF, VEGF, and the VEGF receptor sFlt-1 were measured by enzyme-linked immunosorbent assay. Results-VEGF, sFlt-1, and TF were significantly different between the 3 groups, with abnormal levels in AF and CAD patients compared with control subjects (PϽ0.001, Pϭ0.022, and Pϭ0.008, respectively). Among the AF patients, TF levels were significantly correlated with VEGF (Spearman's rϭ0.65, PϽ0.001) and sFlt (rϭ0.54, Pϭ0.006) levels. Only TF and VEGF levels were significantly correlated in CAD patients (rϭ0.39, Pϭ0.02). There were no significant correlations among the healthy control subjects. Conclusions-Patients with chronic AF have high TF levels, in keeping with the prothrombotic state associated with this arrhythmia. The relationships between TF and VEGF and its receptor sFlt-1 in AF suggest a possible role for VEGF in the hypercoagulable state found in AF, as seen in malignancy and atherosclerosis. (Stroke. 2002;33:2187-2191.)