Application of Biomarkers for Risk Stratification in Patients with Atrial Fibrillation.
BACKGROUND
Atrial fibrillation is the most common sustained arrhythmia and an important contributor to cardiovascular morbidity and mortality. Several strategies have been proposed for prediction of outcomes and individualization of treatments to better balance the benefits of stroke prevention and risks of bleeding during anticoagulation.


BACKGROUND
The availability of analytically more specific and sensitive methods to measure circulating biomarkers of cellular and organ stress and dysfunction has led to testing of their utility in several cardiovascular conditions. In patients with atrial fibrillation, biomarkers of myocardial injury (troponin) and cardiovascular stress and dysfunction (natriuretic peptides, growth differentiation factor 15), myocardial fibrosis (galectin-3), renal dysfunction (creatinine, cystatin C), inflammation (C-reactive protein, cytokines) and coagulation activity (d-dimer) have been found associated with underlying pathophysiology, clinical outcomes and effects of treatment. Measurements of these markers might therefore expand the understanding of the pathophysiology, improve risk assessment and optimize treatment in individual patients with atrial fibrillation.


CONCLUSIONS
Biomarkers for risk stratification have potential roles as tools for evaluation of patients with atrial fibrillation and for selection of the best treatment strategies to prevent stroke, major bleeding, and mortality.
Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden; Ziad.Hijazi@ucr.uu.se.|Uppsala Clinical Research Center (UCR), Uppsala University, Uppsala, Sweden.
Ziad
Z
Hijazi
Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.|Uppsala Clinical Research Center (UCR), Uppsala University, Uppsala, Sweden.
Jonas
J
Oldgren
Uppsala Clinical Research Center (UCR), Uppsala University, Uppsala, Sweden.|Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden.
Agneta
A
Siegbahn
Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.|Uppsala Clinical Research Center (UCR), Uppsala University, Uppsala, Sweden.
Lars
L
Wallentin
D001281:Atrial Fibrillation / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood; D006801:Humans; D018570:Risk Assessment
D015415:Biomarkers