Abstract
Background
Atrial fibrillation (AF) has been associated with an increased risk of silent brain
infarcts (SBI) and cognitive impairment, even in patients with low embolic risk. We
aimed to test the association between 11 blood-biomarkers representing different AF-related
pathways, and SBI, white matter hyperintensities (WMH), and cognitive decline in patients
with AF and low embolic risk.
Methods
The present study followed a cross-sectional design. 70 patients with a history of
AF and CHADS2 score ≤1, and 10 controls with neither AF nor SBI were included. All patients underwent
a 3T brain MRI. Cortical and large subcortical ischemic lesions were considered presumed
embolic origin lesions. White matter hyperintensities (WMH) were measured according
to the Fazekas scale. A subset of patients underwent cognitive evaluation with the
MoCA test. Circulating proteins were measured under blind conditions in a laboratory
at Roche Diagnostics, Germany.
Results
45 patients presented SBI in the MRI, and 25 did not. Ang-2, FGF-23, and BMP-10 were
increased in patients with SBI. Ang-2 was elevated only in patients with embolic infarcts,
whereas FGF-23 and BMP-10 tended to be elevated in patients with both types of infarcts.
Ang-2 (OR = 1.56 [0.94-2.59], p = 0.087), and BMP-10 (OR = 4.83 [0.99–23.60], p = 0.052) were the biomarkers that showed the highest association with SBI when entered
in a multivariable logistic regression model corrected by age. No biomarker was found
associated with WMH or mild cognitive impairment.
Conclusions
BMP-10, and Ang-2 were increased in patients with SBI. Its usefulness to detect SBI
in AF patients should be further explored.
Keywords
Abbreviations:
SBI (Silent brain infarcts), WMH (White matter hyperintensities), AF (atrial fibrillation)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: October 26, 2022
Accepted:
October 11,
2022
Received in revised form:
September 28,
2022
Received:
August 16,
2022
Footnotes
Grant support: A Junta de Andalucía grant (PIN-0144-2016) supported partially the study. The Fundación Cajasol contributed to the study. Neurovascular Research Groups at Seville and Barcelona are part of the Spanish Neurovascular Disease Research Network (RICORS-ICTUS, RD21/0006/0007). Some authors are partially funded by European Union's Horizon 2020 research and innovation program under grant agreements 847770 and 754517.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106833
Copyright
© 2022 Elsevier Inc. All rights reserved.
