Do novel biomarkers of inflammation, oxidative stress, and neurohumoral activation associate with manifest atrial fibrillation in the general population?
In a general population cohort, biomarkers of vascular function (MR-proADM), inflammation (fibrinogen), and myocardial damage (TnI ultra), along with natriuretic peptides, were strongly associated with prevalent atrial fibrillation and improved risk reclassification.
BACKGROUND: Different biological pathways have been related to atrial fibrillation (AF). Novel biomarkers capturing inflammation, oxidative stress, and neurohumoral activation have not been investigated comprehensively in AF. METHODS AND RESULTS: In the population-based Gutenberg Health Study (n = 5000), mean age 56 ± 11 years, 51% males, we measured ten biomarkers representing inflammation (C-reactive protein, fibrinogen), cardiac and vascular function (midregional pro adrenomedullin MR-proADM, midregional pro atrial natriuretic peptide MR-proANP, N-terminal pro-B-type natriuretic peptide Nt-proBNP, sensitive troponin I ultra TnI ultra, copeptin, and C-terminal pro endothelin-1), and oxidative stress (glutathioneperoxidase-1, myeloperoxidase) in relation to manifest AF (n = 161 cases). Individuals with AF were older, mean age 64.9 ± 8.3, and more often males, 71.4%. In Bonferroni-adjusted multivariable regression analyses strongest associations per standard deviation increase in biomarker concentrations were observed for the natriuretic peptides Nt-proBNP (odds ratio OR 2.89, 99.5% confidence interval CI 2.14-3.90; P13%. CONCLUSIONS: In conclusion, in our large, population-based study, we identified novel biomarkers reflecting vascular function, MR-proADM, inflammation, and myocardial damage, TnI ultra, as related to AF; the strong association of natriuretic peptides was confirmed. Prospective studies need to examine whether risk prediction of AF can be enhanced beyond clinical risk factors using these biomarkers.
Schnabel et al. (Mon,) studied this question.
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