Association Between Apelin and Atrial Fibrillation in Patients With High Risk of Ischemic Stroke

Abstract

Background: Atrial fibrillation (AF) is associated with high risk of stroke preventable by timely initiation of anticoagulation. Currently available screening tools based on ECG are not optimal due to inconvenience and high costs. Aim of this study was to study the diagnostic value of apelin for AF in patients with high risk of stroke.Methods: We designed a multicenter, matched-cohort study. The population consisted of three study groups: a healthy control group (34 patients) and two matched groups of 60 patients with high risk of stroke (AF and non-AF group). Apelin levels were examined from peripheral blood.Results: Apelin was significantly lower in AF group compared to non-AF group (0.694 ± 0.148 vs. 0.975 ± 0.458 ng/ml, p = 0.001) and control group (0.982 ± 0.060 ng/ml, p < 0.001), respectively. Receiver operating characteristic (ROC) analysis of apelin as a predictor of AF scored area under the curve (AUC) of 0.658. Apelin's concentration of 0.969 [ng/ml] had sensitivity = 0.966 and specificity = 0.467. Logistic regression based on manual feature selection showed that only apelin and NT-proBNP were independent predictors of AF. Logistic regression based on selection from bivariate analysis showed that only apelin was an independent predictor of AF. A logistic regression model using repeated stratified K-Fold cross-validation strategy scored an AUC of 0.725 ± 0.131.Conclusions: Our results suggest that apelin might be used to rule out AF in patients with high risk of stroke.

The beneficial roles of apelin-13/APJ system in cerebral ischemia: Pathogenesis and therapeutic strategies

“…Atrial fibrillation (AF) is associated with a high risk of stroke, and should therefore be detected in a timely manner. Bohm et al (2021) showed that apelin levels were significantly lower in stroke patients with AF compared to the non-AF group in a multicenter, matched-cohort, and only apelin was identified as an independent predictor of AF. Thus, apelin administration should be considered in patients with high risk of stroke to exclude the possibility of AF.…”

Left Ventricular Hypertrophy and Ventricular Tachyarrhythmia: The Role of Biomarkers

“…Because of its role in many pathophysiological and physiological processes including oxidative stress and inflammation, apelin has been studied as a potential biomarker for several diseases including diabetes [ 79 ], atrial fibrillation [ 80 , 81 , 82 ], cancer [ 83 ], liver disease [ 84 ], and many others.…”

Plasmatic apelin shows a promising potential as a screening biomarker for atrial fibrillation

“…such as a biomarker detectable in peripheral blood, would be signifi cantly benefi cial in the management of AF patients and several biomarkers have already been investigated in this context (13)(14)(15)(16)(17). Based on available literature and our prior research apelin shows promising results (18)(19)(20)(21).…”

“…Our previous research included two studies in patients with low risk of stroke and one in patients with high risk (18,19,21). In this study we pooled all patients from previous studies including previously unreported patients excluded in patient matching, forming a large heterogenous study population with a goal to further investigate apelin's predictive value for AF.…”

“…AF was excluded based on the history and 12-lead ECG at the time of enrolment. Patients were pooled from our previous apelin study populations (18,19,21). Inclusion criteria for each study are available in the supplementary material.…”