Blood-biomarkers and devices for atrial fibrillation screening : Lessons learned from the AFRICAT (Atrial Fibrillation Research In CATalonia) study
Palà, Elena (Hospital Universitari Vall d'Hebron)
Bustamante, Alejandro (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Clua Espuny, Jose Luis (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Acosta, Juan (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Gonzalez-Loyola, Felipe (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Santos, Sara Dos (Institut Català de la Salut)
Ribas-Segui, Domingo (Institut Català de la Salut)
Ballesta-Ors, Juan (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Penalba, Anna (Hospital Universitari Vall d'Hebron)
Giralt Arnaiz, Marina (Hospital Universitari Vall d'Hebron)
Lechuga-Duran, Iñigo (Institut Català Salut Tortosa)
Gentille-Lorente, Delicia (Institut Català Salut Tortosa)
Pedrote, Alonso (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Muñoz, Miguel-Angel (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Montaner, Joan (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Date:	2022
Abstract:	AFRICAT is a prospective cohort study intending to develop an atrial fibrillation (AF) screening program through the combination of blood markers, rhythm detection devices, and long-term monitoring in our community. In particular, we aimed to validate the use of NT-proBNP, and identify new blood biomarkers associated with AF. Also, we aimed to compare AF detection using various wearables and long-term Holter monitoring. 359 subjects aged 65-75 years with hypertension and diabetes were included in two phases: Phase I (n = 100) and Phase II (n = 259). AF diagnosis was performed by baseline 12-lead ECG, 4 weeks of Holter monitoring (Nuubo TM), and/or medical history. An aptamer array including 1310 proteins was measured in the blood of 26 patients. Candidates were selected according to p-value, logFC and biological function to be tested in verification and validation phases. Several screening devices were tested and compared: AliveCor, Watch BP, MyDiagnostick and Fibricheck. AF was present in 34 subjects (9. 47%). The aptamer array revealed 41 proteins with differential expression in AF individuals. TIMP-2 and ST-2 were the most promising candidates in the verification analysis, but none of them was further validated. NT-proBNP (log-transformed) (OR = 1. 934; p<0. 001) was the only independent biomarker to detect AF in the whole cohort. Compared to an ECG, WatchBP had the highest sensitivity (84. 6%) and AUC (0. 895 [0. 780-1]), while MyDiagnostick showed the highest specificity (97. 10%). The inclusion and monitoring of a cohort of primary care patients for AF detection, together with the testing of biomarkers and screening devices provided useful lessons about AF screening in our community. An AF screening strategy using rhythm detection devices and short monitoring periods among high-risk patients with high NT-proBNP levels could be feasible.
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Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	PloS one, Vol. 17 (august 2022) , ISSN 1932-6203

DOI: 10.1371/journal.pone.0273571
PMID: 35998199

15 p, 1.2 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
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