Serum neurofilament light chain in functionally relevant coronary artery disease and adverse cardiovascular outcomes
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Serum neurofilament light chain in functionally relevant coronary artery disease and adverse cardiovascular outcomes. / Amrein, Melissa; Meier, Stephanie; Schäfer, Ibrahim; Schaedelin, Sabine; Willemse, Eline; Benkert, Pascal; Walter, Joan; Puelacher, Christian; Zimmermann, Tobias; Median, Daniela; Egli, Caroline; Leppert, David; Twerenbold, Raphael; Zellweger, Michael; Kuhle, Jens; Mueller, Christian.
in: BIOMARKERS, Jahrgang 28, Nr. 3, 05.2023, S. 341-351.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Serum neurofilament light chain in functionally relevant coronary artery disease and adverse cardiovascular outcomes
AU - Amrein, Melissa
AU - Meier, Stephanie
AU - Schäfer, Ibrahim
AU - Schaedelin, Sabine
AU - Willemse, Eline
AU - Benkert, Pascal
AU - Walter, Joan
AU - Puelacher, Christian
AU - Zimmermann, Tobias
AU - Median, Daniela
AU - Egli, Caroline
AU - Leppert, David
AU - Twerenbold, Raphael
AU - Zellweger, Michael
AU - Kuhle, Jens
AU - Mueller, Christian
PY - 2023/5
Y1 - 2023/5
N2 - Background: Functionally relevant coronary artery disease (fCAD), causing symptoms of myocardial ischemia, can currently only be reliably detected with advanced cardiac imaging. Serum neurofilament light chain (sNfL) is a biomarker for neuro-axonal injury known to be elevated by cardiovascular (CV) risk factors and cerebrovascular small-vessel diseases. Due to their pathophysiological similarities with fCAD and the link to CV risk factors, we hypothesised that sNfL may have diagnostic and prognostic value for fCAD and adverse cardiovascular outcomes.Methods: Of the large prospective Basel VIII study (NCT01838148), 4'016 consecutive patients undergoing cardiac work-up for suspected fCAD were included (median age 68 years, 32.5% women, 46.9% with history of CAD). The presence of fCAD was adjudicated using myocardial perfusion imaging single-photon emission tomography (MPI-SPECT) and coronary angiography. sNfL was measured using a high-sensitive single-molecule array assay. All-cause and cardiovascular death, myocardial infarction (MI), and stroke/transient ischaemic attack (TIA) during 5-year follow-up were the prognostic endpoints.Results: The diagnostic accuracy of sNfL for fCAD as quantified by the area under the curve (AUC) was low (0.58, 95%CI 0.56-0.60). sNfL was strongly associated with age, renal dysfunction, and body mass index and was a strong and independent predictor of all-cause death, cardiovascular death, and stroke/TIA but not MI. Time-dependent AUC for cardiovascular-death at 1-year was 0.85, 95%CI 0.80-0.89, and 0.81, 95%CI 0.77-0.86 at 2-years.Conclusion: While sNfL concentrations did not show a diagnostic role for fCAD, in contrast, sNfL was a strong and independent predictor of cardiovascular outcomes, including all-cause death, cardiovascular death and stroke/TIA.
AB - Background: Functionally relevant coronary artery disease (fCAD), causing symptoms of myocardial ischemia, can currently only be reliably detected with advanced cardiac imaging. Serum neurofilament light chain (sNfL) is a biomarker for neuro-axonal injury known to be elevated by cardiovascular (CV) risk factors and cerebrovascular small-vessel diseases. Due to their pathophysiological similarities with fCAD and the link to CV risk factors, we hypothesised that sNfL may have diagnostic and prognostic value for fCAD and adverse cardiovascular outcomes.Methods: Of the large prospective Basel VIII study (NCT01838148), 4'016 consecutive patients undergoing cardiac work-up for suspected fCAD were included (median age 68 years, 32.5% women, 46.9% with history of CAD). The presence of fCAD was adjudicated using myocardial perfusion imaging single-photon emission tomography (MPI-SPECT) and coronary angiography. sNfL was measured using a high-sensitive single-molecule array assay. All-cause and cardiovascular death, myocardial infarction (MI), and stroke/transient ischaemic attack (TIA) during 5-year follow-up were the prognostic endpoints.Results: The diagnostic accuracy of sNfL for fCAD as quantified by the area under the curve (AUC) was low (0.58, 95%CI 0.56-0.60). sNfL was strongly associated with age, renal dysfunction, and body mass index and was a strong and independent predictor of all-cause death, cardiovascular death, and stroke/TIA but not MI. Time-dependent AUC for cardiovascular-death at 1-year was 0.85, 95%CI 0.80-0.89, and 0.81, 95%CI 0.77-0.86 at 2-years.Conclusion: While sNfL concentrations did not show a diagnostic role for fCAD, in contrast, sNfL was a strong and independent predictor of cardiovascular outcomes, including all-cause death, cardiovascular death and stroke/TIA.
KW - Humans
KW - Female
KW - Aged
KW - Male
KW - Coronary Artery Disease
KW - Ischemic Attack, Transient
KW - Prospective Studies
KW - Intermediate Filaments
KW - Prognosis
KW - Stroke/diagnosis
KW - Myocardial Infarction
U2 - 10.1080/1354750X.2023.2172211
DO - 10.1080/1354750X.2023.2172211
M3 - SCORING: Journal article
C2 - 36714921
VL - 28
SP - 341
EP - 351
JO - BIOMARKERS
JF - BIOMARKERS
SN - 1354-750X
IS - 3
ER -