Biomarkers in atrial fibrillation: an overview

Authors

  • J. A. Vílchez,

    1. Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, University of Murcia, Murcia, Spain
    2. Department of Clinical Analysis, Hospital Universitario Virgen de la Arrixaca, University of Murcia, Murcia, Spain
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  • V. Roldán,

    1. Hematology and Medical Oncology Unit, Hospital Universitario Morales Meseguer, University of Murcia, Murcia, Spain
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  • D. Hernández-Romero,

    1. Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, University of Murcia, Murcia, Spain
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  • M. Valdés,

    1. Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, University of Murcia, Murcia, Spain
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  • G. Y. H. Lip,

    1. University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK
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  • F. Marín

    Corresponding author
    1. Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, University of Murcia, Murcia, Spain
    • Correspondence to:

      Francisco Marín, MD, PhD, Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, Universidad de Murcia, Ctra Madrid-Cartagena s/n, Murcia, 30120, Spain

      Tel.: 0034 968398115

      Fax: 0034 968369662

      Email: fcomarino@hotmail.com

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  • Disclosure

    None declared in relation to this manuscript for all authors. VR has received funding for consultancy and lecturing from Bristol-Myers-Squibb, Bayer and Boehringer Ingelheim. FM has received funding for research, consultancy and lecturing from Abbott, Boston Scientifics, Bayer, Astra Zeneca, Daiichi-Sankyo, BMS/Pfizer and Boehringer Ingelheim. GYHL has served as a consultant for Bayer, Astellas, Merck, Astra-Zeneca, Sanofi-Aventis, Aryx, Portola, Biotronic, and Boehringer-Ingelheim and has been on the speaker bureau for Bayer, Boehringer-Ingelheim, and Sanofi-Aventis.

Summary

Atrial fibrillation (AF) confers a raised risk of stroke and death, and this risk of adverse events is increased by the coexistence of other cardiovascular risk factors. The pathophysiology of AF is complex, involving the role of inflammation, structural remodelling with apoptosis, inflammation or fibrosis. These changes confer a prothrombotic or hypercoagulable state in this arrhythmia. Despite being easy to use for decision-making concerning oral anticoagulant therapy in AF, clinical risk scores used for stratification have shown modest capability in predicting thromboembolic events, and biomarkers may improve our identification of ‘high risk’ patients. Biomarkers, whether measured in the peripheral blood, urine or imaging-based may improve our knowledge of the pathophysiology of AF. Importantly these biomarkers could help in the assessment of AF prognosis. The aim of this review was to summarise the published data about biomarkers studied in AF, with focus on data from randomised prospective clinical trials and large community-based cohorts. We will also review the application of these biomarkers to prognosis on the main schemes used to help stratify risk in AF.

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