Biomarkers Associated with Stroke Risk in Atrial Fibrillation.

Atrial fibrillation arrythmia biomarkers cardioembolic stroke stroke prediction thromboembolism.

Journal

Current medicinal chemistry
ISSN: 1875-533X
Titre abrégé: Curr Med Chem
Pays: United Arab Emirates
ID NLM: 9440157

Informations de publication

Date de publication:
2019
Historique:
received: 15 11 2016
revised: 08 12 2016
accepted: 16 12 2016
pubmed: 20 7 2017
medline: 18 5 2019
entrez: 20 7 2017
Statut: ppublish

Résumé

Atrial fibrillation (AF) is associated with an increased risk of cardioembolic stroke. The risk of cardioembolism is not adequately reduced with the administration of oral anticoagulants, since a number of patients continue to experience thromboembolic events despite receiving treatment. Therefore, identification of a circulating biomarker to identify these high-risk patients would be clinically beneficial. In the present article, we aim to review the available data regarding use of biomarkers to predict cardioembolic stroke in patients with AF. We performed a thorough search of the literature in order to analyze the biomarkers identified thus far and critically evaluate their clinical significance. A number of biomarkers have been proposed to predict cardioembolic stroke in patients with AF. Some of them are already used in the clinical practice, such as d-dimers, troponins and brain natriuretic peptide. Novel biomarkers, such as the inflammatory growth differentiation factor-15, appear to be promising, while the role of micro-RNAs and genetics appear to be useful as well. Even though these biomarkers are associated with an increased risk for thromboembolism, they cannot accurately predict future events. In light of this, the use of a scoring system, that would incorporate both circulating biomarkers and clinical factors, might be more useful. Recent research has disclosed several biomarkers as potential predictors of cardioembolic stroke in patients with AF. However, further research is required to establish a multifactorial scoring system that will identify patients at high-risk of thromboembolism, who would benefit from more intensive treatment and monitoring.

Sections du résumé

BACKGROUND BACKGROUND
Atrial fibrillation (AF) is associated with an increased risk of cardioembolic stroke. The risk of cardioembolism is not adequately reduced with the administration of oral anticoagulants, since a number of patients continue to experience thromboembolic events despite receiving treatment. Therefore, identification of a circulating biomarker to identify these high-risk patients would be clinically beneficial.
OBJECTIVE OBJECTIVE
In the present article, we aim to review the available data regarding use of biomarkers to predict cardioembolic stroke in patients with AF.
METHODS METHODS
We performed a thorough search of the literature in order to analyze the biomarkers identified thus far and critically evaluate their clinical significance.
RESULTS RESULTS
A number of biomarkers have been proposed to predict cardioembolic stroke in patients with AF. Some of them are already used in the clinical practice, such as d-dimers, troponins and brain natriuretic peptide. Novel biomarkers, such as the inflammatory growth differentiation factor-15, appear to be promising, while the role of micro-RNAs and genetics appear to be useful as well. Even though these biomarkers are associated with an increased risk for thromboembolism, they cannot accurately predict future events. In light of this, the use of a scoring system, that would incorporate both circulating biomarkers and clinical factors, might be more useful.
CONCLUSIONS CONCLUSIONS
Recent research has disclosed several biomarkers as potential predictors of cardioembolic stroke in patients with AF. However, further research is required to establish a multifactorial scoring system that will identify patients at high-risk of thromboembolism, who would benefit from more intensive treatment and monitoring.

Identifiants

pubmed: 28721825
pii: CMC-EPUB-84833
doi: 10.2174/0929867324666170718120651
doi:

Substances chimiques

Biomarkers 0

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

803-823

Informations de copyright

Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.

Auteurs

Adam Ioannou (A)

Royal Free Hospital, London, United Kingdom.

Nikolaos Papageorgiou (N)

Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom.

Debbie Falconer (D)

University College London Hospital, London, United Kingdom.

Onkar Rehal (O)

University College London Hospital, London, United Kingdom.

Emma Sewart (E)

University College London Medical School, London, United Kingdom.

Effimia Zacharia (E)

1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece.

Konstantinos Toutouzas (K)

1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece.

Charalambos Vlachopoulos (C)

1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece.

Gerasimos Siasos (G)

1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece.

Costas Tsioufis (C)

1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece.

Dimitris Tousoulis (D)

1st Cardiology Department, Athens University Medical School, Hippokration Hospital, Athens, Greece.

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Classifications MeSH