Serum Neurofilament Light Chain in Patients With Atrial Fibrillation

Karl Sjölin, Julia Aulin, Lars Wallentin, Niclas Eriksson, Claes Held, Kim Kultima, Jonas Oldgren, Joachim Burman, Karl Sjölin, Julia Aulin, Lars Wallentin, Niclas Eriksson, Claes Held, Kim Kultima, Jonas Oldgren, Joachim Burman

Abstract

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. Trial Registration ClinicalTrials.gov NCT00799903.

Keywords: ECG; atrial fibrillation; brain health; neurofilament light chain; pathophysiology.

Figures

Figure 1. Flowchart of patient selection.
Figure 1. Flowchart of patient selection.
AF indicates atrial fibrillation; and TIA, transient ischemic attack.
Figure 2. Levels of sNFL in patients…
Figure 2. Levels of sNFL in patients without AF (control) and with AF.
Box represent interquartile range (IQR), whiskers min‐max within 1.5xIQR, thick line represents median and X marks the geometric mean. AF indicates atrial fibrillation; and sNFL, serum neurofilament light chain.
Figure 3. Levels of sNFL in patients…
Figure 3. Levels of sNFL in patients without AF (control), with AF but without current AF‐rhythm on ECG (AF ECG−), and AF with current AF‐rhythm on ECG (AF ECG+).
Box represent interquartile range (IQR), whiskers min‐max within 1.5xIQR, thick line represents median and X marks the geometric mean. AF indicates atrial fibrillation; and sNFL, serum neurofilament light chain.

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