Arrhythmias & electrophysiology
Neurofilament Light Chain and Risk of Stroke in Patients With Atrial Fibrillation
Authors' conclusion
NFL reflects overt and covert episodes of cerebral ischemia and improves risk assessment of stroke and death in patients with AF without oral anticoagulation, including in patients without previous stroke.
Study context
- Population
- Patients with atrial fibrillation (AF) not receiving OAC, randomised to aspirin in ACTIVE A (2003–2008) and AVERROES (2007–2009)
- Participants
- 3,077 patients
- Exposure
- Higher vs lower plasma NFL
- Outcome
- Stroke or systemic embolism
- Follow-up
- Median 1.5 years
Methodological detailspost hoc analysis of aspirin-treated patients in ACTIVE A and AVERROES trials
- Post hoc analysis of aspirin-treated patients in ACTIVE A and AVERROES trials
Main finding
As reported in the abstract
Stroke or systemic embolism (n=206)
NFL per doublingHazard ratio (95% CI)
Adjusted for clinical characteristics
1.27(1.10–1.46)
Adjusted also for other biomarkers
1.18(1.01–1.37)
Per doubling, as printed
- C index for stroke, NFL alone (on par with clinical risk scores)
- 0.642
- C index, NFL added to clinical information, NT-proBNP and hs-cTnT
- 0.727
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Stroke or systemic embolism, patients without previous stroke (subgroup) | 1.23 (1.02–1.48) | |
| 0.512Hazard ratio (log scale) |
CV death (n=219) and all-cause death (n=311)
- NFL independently associated with CV and all-cause death
Baseline NFL level
- Median NFL 16.9 ng/L (IQR 11.1-26.5 ng/L)
Original publication
Neurofilament Light Chain and Risk of Stroke in Patients With Atrial Fibrillation. Circulation. Published 24 July 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →