Atrial fibrillation (AF) is one of the most common cardiac arrhythmias worldwide, and it increases the risk of ischemic stroke (IS). Atrial Fibrillation (AF) is also a known risk factor for heart failure (HF), cognitive impairment, as well as significant morbidity, disability, and mortality.
Anticoagulation therapy options and duration in patients with non-valvular AF (NVAF) are frequently guided by IS risk assessment methods. The CHA2DS2-VASc score has been extensively validated, and well-known standards now recommend it. This score, on the other hand, is highly influenced by age, sex, and comorbidities and has only moderate predictive potential. One of the most promising areas in the prevention and treatment of NVAF is the development of effective and verified clinical biomarkers to aid in customized IS risk assessment.
The clinical use and efficacy of AF feature, cardiac imaging and ECG markers, arterial stiffness and atherosclerosis-related markers, circulating biomarkers, and novel genetic markers in the diagnosis of IS and management of patients with NVAF are discussed in this review. The goal of this review is to update physicians and researchers on biomarker advancements in AF-related IS.
Simple, affordable, practical, and high sensitivity are some of the necessary characteristics of a good biomarker. Non-paroxysmal AF type, carotid plaque, cardiac troponin, NT-proBNP, and D-dimer, according to current research, are some of the promising biomarkers for IS in NVAF patients because they strike a good balance between practicality and simplicity. In NVAF, there is no agreement on a promising biomarker for IS risk classification, and enrolling these biomarkers into existing models is similarly tricky. To improve IS prediction in patients with NVAF, more prospective cohorts and trials are needed to combine diverse clinical risk factors and biomarkers.