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Published on: July 20, 2022
Biomarkers Associated with Stroke Risk in Atrial Fibrillation
Adam Ioannou1, Nikolaos Papageorgiou2, Debbie Falconer3
1Royal Free Hospital, London, United Kingdom.
Insights
Biomarkers can help predict cardioembolic stroke in atrial fibrillation (AF) patients, but current options are insufficient. A comprehensive scoring system integrating biomarkers and clinical factors is needed for better risk stratification and treatment.
Area of Science:
- Cardiology
- Biomarker Discovery
- Stroke Prevention
Background:
- Atrial fibrillation (AF) significantly increases cardioembolic stroke risk.
- Existing oral anticoagulants do not fully mitigate this risk, leaving patients vulnerable to recurrent thromboembolic events.
- Identifying reliable biomarkers for high-risk AF patients is crucial for clinical benefit.
Purpose of the Study:
- To review and analyze existing data on biomarkers for predicting cardioembolic stroke in AF patients.
- To critically evaluate the clinical significance and predictive accuracy of identified biomarkers.
Main Methods:
- A comprehensive literature search was conducted.
- Analysis focused on biomarkers identified for cardioembolic stroke prediction in AF.
- Evaluation of clinical significance and predictive utility of these biomarkers.
Main Results:
- Several biomarkers, including d-dimers, troponins, and brain natriuretic peptide, are used clinically.
- Emerging biomarkers like growth differentiation factor-15, micro-RNAs, and genetic markers show promise.
- Current biomarkers, while indicating increased risk, lack precise predictive accuracy for future events.
Conclusions:
- Multiple biomarkers show potential for predicting cardioembolic stroke in AF.
- Further research is necessary to develop a multifactorial scoring system.
- Such a system could identify high-risk patients for intensified treatment and monitoring.
Background:
Atrial fibrillation (AF) is associated with an increased risk of cardioembolic stroke. The risk of cardioembolism is not adequately reduced with the administration of oral anticoagulants, since a number of patients continue to experience thromboembolic events despite receiving treatment. Therefore, identification of a circulating biomarker to identify these high-risk patients would be clinically beneficial.
Objective:
In the present article, we aim to review the available data regarding use of biomarkers to predict cardioembolic stroke in patients with AF.
Methods:
We performed a thorough search of the literature in order to analyze the biomarkers identified thus far and critically evaluate their clinical significance.
Results:
A number of biomarkers have been proposed to predict cardioembolic stroke in patients with AF. Some of them are already used in the clinical practice, such as d-dimers, troponins and brain natriuretic peptide. Novel biomarkers, such as the inflammatory growth differentiation factor-15, appear to be promising, while the role of micro-RNAs and genetics appear to be useful as well. Even though these biomarkers are associated with an increased risk for thromboembolism, they cannot accurately predict future events. In light of this, the use of a scoring system, that would incorporate both circulating biomarkers and clinical factors, might be more useful.
Conclusions:
Recent research has disclosed several biomarkers as potential predictors of cardioembolic stroke in patients with AF. However, further research is required to establish a multifactorial scoring system that will identify patients at high-risk of thromboembolism, who would benefit from more intensive treatment and monitoring.
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