Association of blood-based biomarkers with radiologic markers and cognitive decline in atrial fibrillation patients

Palà E, Escudero-Martínez I, Penalba A, Bustamante A, Lamana-Vallverdú M et al. J Stroke Cerebrovasc Dis. 2022 Dec;31(12):106833. doi: 10.1016/j.jstrokecerebrovasdis.2022.106833. Epub 2022 Oct 26.PMID: 36309005
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 [0.9923.60], 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.
Funding: A Junta de Andalucía grant (PIN-0144-2016) supported partially the study. The Fundacion 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).