Frontiers in Cardiovascular Medicine (Oct 2021)

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

  • Allan Bohm,
  • Allan Bohm,
  • Allan Bohm,
  • Peter Snopek,
  • Peter Snopek,
  • Lubomira Tothova,
  • Lubomira Tothova,
  • Branislav Bezak,
  • Branislav Bezak,
  • Branislav Bezak,
  • Nikola Jajcay,
  • Nikola Jajcay,
  • Marianna Vachalcova,
  • Marianna Vachalcova,
  • Tomas Uher,
  • Marian Kurecko,
  • Viera Kissova,
  • Katarina Danova,
  • Peter Olejnik,
  • Peter Olejnik,
  • Peter Michalek,
  • Tereza Hlavata,
  • Tereza Hlavata,
  • Katarina Petrikova,
  • Viliam Mojto,
  • Jan Kyselovic,
  • Stefan Farsky

DOI
https://doi.org/10.3389/fcvm.2021.742601
Journal volume & issue
Vol. 8

Abstract

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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.

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