Serum Neurofilament Light Chain in Patients With Atrial Fibrillation

by Selleckchem | Jun 12 2023

Background Atrial fibrillation (AF) is associated with stroke and MRI features of cerebral tissue damage but its impact on levels of serum neurofilament light chain (sNFL), an established biochemical marker of neuroaxonal damage, is unknown. Methods and Results In this observational study, sNFL was analyzed in 280 patients with AF and 280 controls without AF matched for age, sex, and diabetes status within the STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy) trial. None of the patients had a history of previous stroke or transient ischemic attack. Patients with a diagnosis of AF were divided into two groups based on if they were in AF rhythm at the time of blood sampling (AF ECG+, n=74), or not (AF ECG-, n=206). Multiple linear regression analysis was performed to adjust for clinical risk factors. In patients with AF, the levels of sNFL were 15% (AF ECG+) and 10% (AF ECG-) higher than in the control group after adjustment for clinical risk factors, P=0.047 and 0.04, respectively. There was no association between anticoagulation treatment and sNFL levels. Conclusions sNFL was elevated in patients with AF compared with matched controls without AF. Ongoing AF rhythm was associated with even higher levels of sNFL than in patients with a diagnosis of AF but currently not in AF rhythm. Anticoagulation treatment did not affect sNFL levels.

Comments:

The study is an observational study that investigated the levels of serum neurofilament light chain (sNFL), a biochemical marker of neuroaxonal damage, in patients with atrial fibrillation (AF) compared to controls without AF. The study included 280 patients with AF and 280 controls matched for age, sex, and diabetes status.

The patients with AF were further divided into two groups based on whether they were in AF rhythm at the time of blood sampling (AF ECG+) or not (AF ECG-). None of the participants had a history of stroke or transient ischemic attack. Multiple linear regression analysis was performed to adjust for clinical risk factors.

The results showed that in patients with AF, the levels of sNFL were 15% higher in the AF ECG+ group and 10% higher in the AF ECG- group compared to the control group, after adjusting for clinical risk factors. This suggests that patients with AF have increased levels of neuroaxonal damage compared to those without AF.

Interestingly, the study found that patients with ongoing AF rhythm (AF ECG+) had even higher levels of sNFL than patients with a diagnosis of AF but currently not in AF rhythm (AF ECG-). This indicates that the presence of ongoing AF may be associated with further neuroaxonal damage.

The study did not find any association between anticoagulation treatment and sNFL levels. This suggests that the elevation in sNFL observed in patients with AF is not influenced by anticoagulation treatment.

In conclusion, this observational study indicates that patients with AF have elevated levels of sNFL, indicating neuroaxonal damage, compared to matched controls without AF. Ongoing AF rhythm appears to be associated with even higher sNFL levels. Further research is needed to understand the underlying mechanisms and clinical implications of these findings.