Biomarkers of risk and prognosis in atrial fibrillation

Abstract

Atrial fibrillation is one of the most common forms of arrhythmia and is associated with an increased risk of stroke, thromboembolism, and increased mortality among patients with cardiovascular disease. Identifying patients at high risk of developing atrial fibrillation and predicting the likelihood of acute cerebrovascular accidents of cardioembolic origin, as well as other thromboembolic complications, is key to optimizing treatment strategies and preventing complications. This article provides a comprehensive review of existing and new biomarkers used to assess the risk of onset and recurrence of atrial fibrillation, as well as to assess the safety of anticoagulation therapy for this arrhythmia. Genetic, inflammatory and metabolic markers are discussed in detail, as well as the role of oxidative stress in the context of pathophysiological processes, clinical manifestations of the disease and its complications. Particular attention is paid to the evaluation of markers that can be used to predict adverse outcomes and improve diagnostic accuracy. Limitations in the ability to routinely and widely use both existing and promising biomarkers are discussed. Their clinical significance, cost-effectiveness and possibilities for integration into everyday clinical practice are considered. The need for standardization of approaches to the comprehensive assessment of biomarkers, the importance of interdisciplinary collaboration and the development of individualized approaches to the treatment of patients with atrial fibrillation, including the use of biomarker data, are emphasized. Optimizing approaches to assessing patients with atrial fibrillation using current and promising biomarkers can help overcome existing limitations and facilitate their implementation in clinical practice, which in turn will improve diagnosis, treatment and prognosis of patients.