Arrhythmias & electrophysiology

Serum Neurofilament Light Chain and Cardiovascular Outcomes in Patients With Atrial Fibrillation

JAMA CardiolPublished Prospective cohort study

Main finding · MVEs per doubling of sNfLResult — go to the resultAdjusted hazard ratio 1.35 95% CI 1.22–1.50

Authors' conclusion

After multivariable adjustment, sNfL levels were associated with a broad range of adverse cardiovascular events and mortality in patients with AF.

Study context

Population
Patients with documented atrial fibrillation (AF) in the Swiss Atrial Fibrillation Cohort (SWISS-AF), 14 secondary or tertiary care centres in Switzerland, enrolled 2014–2017of 2415 (95.7%)
Participants
2,311 patients
Exposure
Per doubling of sNfL concentration
Outcome
Major vascular events:
  • CV death
  • Nonfatal stroke
  • Nonfatal MI
Follow-up
Median 8.0 years
Methodological detailsmulticentre, observational
  • Multicentre
  • Observational

Main finding

MVEs per doubling of sNfL

Adjusted hazard ratio

1.35

95% CI 1.22–1.50

P < 0.001

Per doubling of sNfL
aHR 1.35 (95% CI 1.22–1.50); P < 0.001

Per doubling of sNfL, as printed

As reported in the abstract

MVE incidence per 100 patient-years (665 first major vascular events (MVEs))
4.4 (95% CI, 4.1-4.8)

Observational data: associations, not effects.

Further findings

Nonfatal stroke

aHR (95% CI)P value
Increasing sNfL1.31 (1.09–1.57)P = 0.004

CV death

aHR (95% CI)P value
Increasing sNfL1.36 (1.20–1.54)P < 0.001

HF-related hospitalization

aHR (95% CI)P value
Increasing sNfL1.25 (1.11–1.41)P < 0.001

All-cause mortality

aHR (95% CI)P value
Increasing sNfL1.41 (1.27–1.56)P < 0.001

MI

aHR (95% CI)P value
Increasing sNfLNot associated1.04 (0.81–1.34)P = 0.76

Original publication

Serum Neurofilament Light Chain and Cardiovascular Outcomes in Patients With Atrial Fibrillation. JAMA Cardiol. Published 1 May 2026. doi:10.1001/jamacardio.2026.0922

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