{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:11:15Z","timestamp":1787019075677,"version":"build-2736575974"},"reference-count":46,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2016,6,16]],"date-time":"2016-06-16T00:00:00Z","timestamp":1466035200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Appl Thromb Hemost"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Increased coagulation activity has been established in paroxysmal atrial fibrillation (PAF), but data on the anticoagulant system are scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To examine the protein C anticoagulant pathway in the early hours of the disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Fifty-one patients (26 men and 25 women; mean age 59.84 \u00b1 1.60 years) and 52 controls (26 men and 26 women; mean age 59.50 \u00b1 1.46 years) were selected for the study. Protein C antigen and its activity, total protein S, free protein S and its activity, soluble forms of endothelial protein C receptor (sEPCR), and thrombomodulin (sTM) were examined in the plasma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The indicators were studied in patients between the 2nd and the 24th hour after the onset of arrhythmia. Levels of protein C were significantly elevated in patients compared to controls (111.40% \u00b1 6.66% vs 94.83% \u00b1 4.47%; P = .039). Protein C activity showed significant reduction in PAF (73.13% \u00b1 5.80% vs 103.3% \u00b1 3.80%; P &lt; .001). Total protein S levels did not differ significantly (108.20% \u00b1 4.07% vs 102.40% \u00b1 3.65%; P = .30). Free protein S (76.81% \u00b1 6.01% vs 122.10% \u00b1 3.97%; P &lt; .001) and its activity (71.39% \u00b1 6.27% vs 119.50% \u00b1 6.54%; P &lt; .001) were reduced in patients. Higher levels of sEPCR (203.10 \u00b1 10.33 vs 133.10 \u00b1 7.37 ng\/mL; P &lt; .001) and sTM (6.50\u00b10.40 vs 4.48\u00b10.28 ng\/mL; P &lt; .001) were measured in PAF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Protein C activity is reduced still in the first hours (until the 24th hour) of PAF clinical manifestation, determining reduced activity of the anticoagulant pathway as a whole. The established low levels of free protein S and its activity as well as low sEPCR and sTM levels are a possible explanation of the changes in protein C activity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1076029616654262","type":"journal-article","created":{"date-parts":[[2016,6,16]],"date-time":"2016-06-16T21:28:04Z","timestamp":1466112484000},"page":"793-799","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Decreased Activity of the Protein C Anticoagulant Pathway in the Early Hours of Paroxysmal Atrial Fibrillation"],"prefix":"10.1177","volume":"23","author":[{"given":"Mariya","family":"Negreva","sequence":"first","affiliation":[{"name":"First Clinic of Cardiology, Varna University Hospital \u201cSt. Marina,\u201d Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svetoslav","family":"Georgiev","sequence":"additional","affiliation":[{"name":"Second Clinic 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