Arrhythmias & electrophysiologyCohort study
Serum Neurofilament Light Chain and Cardiovascular Outcomes in Patients With Atrial Fibrillation
- Prospective cohort study
- multicentre
- observational
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:
- Composite of CV death
- Nonfatal stroke
- Nonfatal MI
- Follow-up
- Median 8.0 years
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
| Comparison | aHR (95% CI) | P value | |
|---|---|---|---|
| Increasing sNfL | 1.31 (1.09–1.57) | P = 0.004 | |
| 0.512Adjusted hazard ratio (log scale) |
CV death
| Comparison | aHR (95% CI) | P value | |
|---|---|---|---|
| Increasing sNfL | 1.36 (1.20–1.54) | P < 0.001 | |
| 0.512Adjusted hazard ratio (log scale) |
HF-related hospitalization
| Comparison | aHR (95% CI) | P value | |
|---|---|---|---|
| Increasing sNfL | 1.25 (1.11–1.41) | P < 0.001 | |
| 0.512Adjusted hazard ratio (log scale) |
All-cause mortality
| Comparison | aHR (95% CI) | P value | |
|---|---|---|---|
| Increasing sNfL | 1.41 (1.27–1.56) | P < 0.001 | |
| 0.512Adjusted hazard ratio (log scale) |
MI
| Comparison | aHR (95% CI) | P value | |
|---|---|---|---|
| Increasing sNfL · not associated | 1.04 (0.81–1.34) | P = 0.76 | |
| 0.512Adjusted hazard ratio (log scale) |
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
Summarised from the published abstract; every number is checked against it