Objective biomarker test could predict heart disease risk for patients with common arrhythmia

Patients who have a common heart arrhythmia called atrial fibrillation (AF) could have one blood test that could assess their risk of cardiovascular events in the following five years, new research involving NIHR Birmingham Biomedical Research Centre researchers has found.

New research published in Cardiovascular Research and presented at the Frontiers in CardioVascular BIology Congress 2024 conference in Amsterdam suggests that a blood-based biomolecule test alone could assess the risk of having a cardiovascular event in the next five years.

The study of 1586 AF patients found that a cluster of high-risk patients who recorded high levels of 13 biomolecules had five times more cardiovascular events than those in the low-risk cluster.

“….one blood test could be used to help predict the risk of cardiovascular events for patients with atrial fibrillation”

Professor Larissa Fabritz

Professor Larissa Fabritz, from the Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg Eppendorf and an Honorary Professor at the University of Birmingham said:

“These validated findings show that one blood test could be used to help predict the risk of cardiovascular events for patients with atrial fibrillation, helping to differentiate healthcare where it’s most needed. Through a further validation study carried out in Birmingham, we are confident that the blood test can give a useful understanding of those in greatest need of interventions to avoid strokes, acute heart failure and death.”

Biomarker profile

The international team developed a profile of 13 specific biomarkers that were used to differentiate risk in atrial fibrillation. Using samples from AF patients, they analysed likely target biomarkers and through the trial and validation in the Birmingham BBC-AF registry found that a combination of elevated biomarkers corresponded with risk variation in patients.

The findings are taken from a subset of the EAST – AFNET 4 (Early Treatment of Atrial Fibrillation for Stroke Prevention) trial which demonstrated that early rhythm control – with antiarrhythmic drugs or atrial fibrillation ablation – delivered within one year after AF diagnosis improves outcomes in 2789 patients with early AF and cardiovascular risk factors compared to usual care (UC) over a 5-year follow-up time.

Paulus Kirchhof, principal investigator of EAST – AFNET 4 and author on the paper said:

“We were fortunate that we precisely could quantify thirteen biomolecules related to different disease processes in the EAST – AFNET 4 biomolecule study, Clustering methods capturing interactions between biomolecules were applied to identify patients at risk of cardiovascular events based on biomolecule concentrations.

“Thereby, four AF subphenotypes with distinct biomolecule profiles and risk of complications were identified. The results provide insights into the drivers of AF-related complications in patients.”