Juan Acosta (Spain)
Hospital Universitario Virgen del Rocio Department of cardiologyAuthor Of 1 Presentation
BLOOD-BASED BIOMARKERS TO IDENTIFY ATRIAL FIBRILLATION IN HIGH-RISK ASYMPTOMATIC INDIVIDUALS AND CRYPTOGENIC STROKE PATIENTS.
Abstract
Background And Aims
Atrial fibrillation (AF) increases the risk of ischemic stroke in asymptomatic individuals and may be the underlying cause of a high amount of cryptogenic stroke cases. Detection of AF would change primary and secondary stroke prevention strategies by recommending oral anticoagulation, but this arrhythmia is usually underdiagnosed. We aimed to test the usefulness of several blood-biomarkers to detect AF in two prospective cohorts.
Methods
492 patients from two studies were included: 274 subjects aged 65-75 years with hypertension and diabetes from the AFRICAT cohort, and 218 cryptogenic stroke patients aged >55 years from the CRYPTOFA cohort. AF was assessed by 4 weeks of monitoring with a wearable Holter device (NuuboTM). Blood was collected before monitoring started. 10 candidate biomarkers were identified by automated immunoassays (Roche, Penzberg) in the plasma of all patients. Univariate and logistic regression analyses were performed in each cohort separately.
Results
AF prevalence was 12.4% and 22.9% in each cohort. 4 biomarkers were significantly increased in asymptomatic individuals with AF (NT-proBNP, Ang-2, Troponin-T, and ESM-1) and 7 biomarkers showed significantly higher levels in cryptogenic stroke patients with AF detection (GDF-15, IL-6, Troponin-T, Ang-2, BMP-10, DKK-3, and NT-proBNP). The combination of Ang-2 and NT-proBNP showed the best performance in both cohorts, with an AUC of 0.772(0.692-0.865) to detect AF in high-risk asymptomatic individuals, and 0.747(0.671-0.823) in cryptogenic stroke patients.
Conclusions
Blood-biomarkers, in particular, NT-proBNP and Ang-2, were increased in AF patients and could be useful in AF screening strategies in the primary care setting, and for searching AF after cryptogenic stroke.