Drabik L, et al. - Researchers performed a longitudinal cohort study including 236 patients with atrial fibrillation (AF) receiving vitamin K antagonists (VKAs) in order to evaluate the association of impaired fibrinolysis with clinical outcomes in AF. Ex vivo plasma clot lysis time (CLT), a measure of global fibrinolysis along, with von Willebrand factor antigen (vWF), plasminogen activator inhibitor 1 antigen (PAI-1), and other fibrinolysis modulators was measured in these patients. Annual rates of death, ischemic cerebrovascular events, and major bleeding were 1.48%, 2.96%, and 3.45%, respectively, during a median follow-up time of 4.3 (interquartile range 3.7-4.8) years. Findings suggest a possible value of impaired fibrinolysis for predicting thromboembolic events in AF patients receiving VKA. The multivariate Cox regression analysis adjusted for potential confounders revealed following as the independent predictors of stroke or TIA: CLT > 115 minutes (hazard ratio [HR] 7.67, 95% confidence interval [CI] 2.78-21.17), PAI-1 (HR 1.16, 95% 1.05-1.28), and CHA₂DS₂-VASc score ≥ 3 (HR 5.18, 95% 1.76-15.29).