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. 2021 Oct 12:8:742601.
doi: 10.3389/fcvm.2021.742601. eCollection 2021.

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

Allan Bohm  1   2   3 , Peter Snopek  4   5 , Lubomira Tothova  6   7 , Branislav Bezak  1   7   8 , Nikola Jajcay  3   9 , Marianna Vachalcova  10   11 , Tomas Uher  3 , Marian Kurecko  10 , Viera Kissova  12 , Katarina Danova  13 , Peter Olejnik  1   7 , Peter Michalek  3 , Tereza Hlavata  2   7 , Katarina Petrikova  3 , Viliam Mojto  2 , Jan Kyselovic  7 , Stefan Farsky  14
Affiliations

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

Allan Bohm et al. Front Cardiovasc Med. .

Abstract

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.

Keywords: apelin; atrial fibrillation; biomarker; electrical atrial remodeling; ischemic stroke.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Apelin concentration: Non-atrial fibrillation patients (non-AF group) vs. atrial fibrillation patients (AF group) vs. control group.
Figure 2
Figure 2
Apelin concentration: Non-atrial fibrillation patients (no-AF) vs. atrial fibrillation patients (AF): (A) correlation between apelin concentration and diastolic dysfunction; (B) correlation between apelin concentration and left atrium diameter; (C) correlation between apelin concentration and NT-proBNP.
Figure 3
Figure 3
Receiver operating characteristic (ROC) analysis of apelin as a predictor of atrial fibrillation (AF).
Figure 4
Figure 4
Logistic regression model (all patient data).
Figure 5
Figure 5
Logistic regression model based on selection from bivariate analysis (predictors with p < 0.1).
Figure 6
Figure 6
Logistic regression model using repeated stratified K-Fold cross-validation strategy.
See this image and copyright information in PMC

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