RT Journal Article
T1 Blood-Based Biomarkers to Search for Atrial Fibrillation in High-Risk Asymptomatic Individuals and Cryptogenic Stroke Patients.
A1 Palà, Elena
A1 Bustamante, Alejandro
A1 Pagola, Jorge
A1 Juega, Jesus
A1 Francisco-Pascual, Jaume
A1 Penalba, Anna
A1 Rodriguez, Maite
A1 De Lera Alfonso, Mercedes
A1 Arenillas, Juan F
A1 Cabezas, Juan Antonio
A1 Pérez-Sánchez, Soledad
A1 Moniche, Francisco
A1 de Torres, Reyes
A1 González-Alujas, Teresa
A1 Clúa-Espuny, Josep Lluís
A1 Ballesta-Ors, Juan
A1 Ribas, Domingo
A1 Acosta, Juan
A1 Pedrote, Alonso
A1 Gonzalez-Loyola, Felipe
A1 Gentile Lorente, Delicia
A1 Ángel Muñoz, Miguel
A1 Molina, Carlos A
A1 Montaner, Joan
K1 atrial fibrillation
K1 biomarkers
K1 cryptogenic stroke
K1 screening
K1 stroke
AB Atrial fibrillation (AF) increases the risk of ischemic stroke in asymptomatic individuals and may be the underlying cause of many cryptogenic strokes. We aimed to test the usefulness of candidate blood-biomarkers related to AF pathophysiology in two prospective cohorts representative of those populations. Two hundred seventy-four subjects aged 65-75 years with hypertension and diabetes from the AFRICAT cohort, and 218 cryptogenic stroke patients aged >55 years from the CRYPTO-AF cohort were analyzed. AF was assessed by 4 weeks of monitoring with a wearable Holter device (NuuboTM™). Blood was collected immediately before monitoring started. 10 candidate biomarkers were measured by automated immunoassays (Roche, Penzberg) in the plasma of all patients. Univariate and logistic regression analyses were performed in each cohort separately. Atrial fibrillation detection rate was 12.4% (AFRICAT cohort) and 22.9% (CRYPTO-AF cohort). 4 biomarkers were significantly increased in asymptomatic individuals with AF [Troponin-T, Angiopoietin-2 (Ang-2), Endocan, and total N-terminal pro-B type natriuretic peptide (NT-proBNP)] and 7 biomarkers showed significantly higher concentrations in cryptogenic stroke patients with AF detection [growth differentiation factor 15, interleukin 6, Troponin-T, Ang-2, Bone morphogenic protein 10, Dickkopf-related protein 3 (DKK-3), and total NT-proBNP]. The models including Ang-2 and total NT-proBNP [AUC 0.764 (0.665-0.863)], and Ang-2 and DKK-3 [AUC = 0.733 (0.654-0.813)], together with age and sex, showed the best performance to detect AF in high-risk asymptomatic individuals, and in cryptogenic stroke patients, respectively. Blood-biomarkers, in particular, total NT-proBNP, DKK-3, and Ang-2, were associated with AF reflecting two mechanistically different pathways involved in AF pathophysiology (AF stretch and vascular changes). The combination of these biomarkers could be useful in AF screening strategies in the primary care setting and also for searching AF after cryptogenic stroke.
SN 2297-055X
YR 2022
FD 2022-07-04
LK http://hdl.handle.net/10668/20551
UL http://hdl.handle.net/10668/20551
LA en
DS RISalud
RD Apr 7, 2025