Atrial fibrillation (AF) is a source of altered brain perfusion and ischemia, potentially
leading to cerebral injury and blood brain barrier (BBB) disruption, which may result
in the permeation of neurospecific molecules into the bloodstream. We retrospectively
analyzed circulating levels of biomarkers of cerebral injury: Astrocyte-specific glial
acidic fibrillary protein (GFAP), calcium-binding protein B (S100 b), stress response
marker growth differential factor 15 (GDF15), and microtubule associated Tau protein,
in patients with AF and non-AF controls. A total of 196 AF cases and 47 non-AF controls
were enrolled in this study all without previous clinical stroke or cerebral injury.
Plasma samples were obtained from the Intermountain INSPIRE biobank registry. AF status
was determined at the time of the sample draw using clinical diagnosis. Assessment
of circulating biomarkers was conducted with EIA. Multivariate linear modeling, using
natural log, and square root transformation of the biomarkers, was done adjusting
for (1) CHA2DS2-VASc and anticoagulation, and (2) age, gender, coronary artery disease and anticoagulation.
Circulating Tau, GDF15, and GFAP were elevated in AF cases. After multivariate adjustment,
GFAP and Tau remained significantly elevated in the AF, whereas the signal for GDF15
was confounded by age. In conclusion, circulating biomarkers of neuronal and glial
injury Tau and GFAP are elevated in patients with AF that are consistent with subclinical
cerebral injury and disruption of the BBB, which can predispose these patients to
the development of cognitive dysfunction and/or dementia later in life.
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Article info
Publication history
Published online: September 06, 2019
Received in revised form:
August 12,
2019
Received:
June 3,
2019
Footnotes
Funding: This research was funded by a grant from the Intermountain Medical Research Foundation, Salt Lake City, Utah.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
