Biomarkers in atrial fibrillation: a clinical review
Abstract
Assessment of atrial fibrillation (AF)-associated stroke risk is at present mainly based on clinical risk scores such as CHADS2 and CHA2DS2-VASc, although these scores provide only modest discrimination of risk for individual patients. Biomarkers derived from the blood may help refine risk assessment in AF for stroke outcomes and for mortality. Recent studies of biomarkers in AF have shown that they can substantially improve risk stratification. Cardiac biomarkers, such as troponin and natriuretic peptides, significantly improve risk stratification in addition to current clinical risk stratification models. Similar findings have recently been described for markers of renal function, coagulation, and inflammation in AF populations based on large randomized prospective clinical trials or large community-based cohorts. These new findings may enable development of novel tools to improve clinical risk assessment in AF. Biomarkers in AF may also improve the understanding of the pathophysiology of AF further as well as potentially elucidate novel treatment targets. This review will highlight novel associations of biomarkers and outcomes in AF as well as recent progress in the use of biomarkers for risk stratification.
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Even short episodes of AF lead to myocardial damage and expression of prothrombotic factors on the atrial endothelial surface, and activation of platelets and inflammatory cells, and contribute to a generalized prothrombotic state.
“Furthermore, even short episodes of AF lead to myocardial damage and expression of prothrombotic factors on the atrial endothelial surface, and activation of platelets and inflammatory cells, and contribute to a generalized prothrombotic state.88,89”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [89]
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Self-citation
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2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
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Self-citation2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
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High-sensitivity assays for troponin in patients with cardiac disease
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Self-citation
- Authors
- Hijazi, Z., Oldgren, J., Siegbahn, A., Granger, C. B., & Wallentin, L.
- Affiliations
- Uppsala University (SE)
- Duke Medical Center (US)
- Corresponding author
- Hijazi, Z.
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-02-05
- Volume
- 34
- Issue
- 20
- Pages
- 1475-1480
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- OpenAlex
- W2169206499
- Cited by
- 298
- References
- 143
- Citations by year
- 2026: 6 · 2025: 18 · 2024: 15 · 2023: 15 · 2022: 18 · 2021: 27 · 2020: 26 · 2019: 25 · 2018: 22 · 2017: 38 · 2016: 31 · 2015: 20 · 2014: 22 · 2013: 15
- FWCI
- 4.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Keywords
- atrial fibrillation, biomarkers, stroke risk, risk stratification, CHA2DS2-VASc score, CHADS2 score, troponin, natriuretic peptides, renal function markers, coagulation markers, inflammatory markers, mortality, pathophysiology
- MeSH terms
- Atrial Fibrillation, C-Reactive Protein, Echocardiography, Fibrin Fibrinogen Degradation Products, Forecasting, Glomerular Filtration Rate, Humans, Biomarkers, Interleukin-6, Risk Assessment, Troponin I, Natriuretic Peptide, Brain, Cystatin C
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