title: 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.
authors: Uppsala Clinical Research Center (UCR), Uppsala University, Uppsala Science Park, Uppsala, Sweden. ziad.hijazi@ucr.uu.se
authors: Ziad
authors: Z
authors: Hijazi
authors: Jonas
authors: J
authors: Oldgren
authors: Agneta
authors: A
authors: Siegbahn
authors: Christopher B
authors: CB
authors: Granger
authors: Lars
authors: L
authors: Wallentin
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D055316:Cystatin C / Q000097:blood; D004452:Echocardiography; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005544:Forecasting; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D020097:Natriuretic Peptide, Brain / Q000097:blood; D018570:Risk Assessment; D019210:Troponin I / Q000097:blood
chemical_list: D015415:Biomarkers; D055316:Cystatin C; D005338:Fibrin Fibrinogen Degradation Products; D015850:Interleukin-6; D019210:Troponin I; C036309:fibrin fragment D; D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein
keywords: Atrial fibrillation; BNP; Biomarkers; CRP; Coagulation; D-dimer; GFR; IL-6; Inflammation; Review; Risk stratification; Stroke risk; Troponin; cystatin C