Atrial fibrillation progresses with atrial changes and raises stroke risk. Early detection cuts major events. Biomarkers offer a way to spot new-onset AF in at-risk patients. This review sums up their power for diagnosis and prevention. It focuses on high-risk groups without prior AF. The analysis was published in the European Journal of Preventive Cardiology.
Rigorous Search and Selection
Team searched PubMed, Scopus, Web of Science, and Google Scholar from January 2014 to November 2025. They followed PRISMA 2020 rules. Excluded studies on specific groups or those with existing or post-op AF. Used Newcastle-Ottawa scale for quality. Reported effects as HR with 95% CIs. Included 10 cohorts with 472,581 patients. New-onset AF occurred in 35,271 (7.5%).
Key Biomarkers and Their Impact
18 biomarkers tied to higher AF risk. NT-proBNP and sVCAM-1 stood out. Meta-analysis gave NT-proBNP an HR of 1.37 (95% CI 1.19-1.59), but with high heterogeneity (I²=80%, p<0.01). Lp(a) raised risk by 3% per 20 mg/dL rise. Nine biomarkers linked to lower risk, like ADAMTS13 (HR 0.78, 95% CI 0.70-0.88). Networks mapped high-risk and low-risk biomarker links.
Shift in AF Management Ahead
NT-proBNP proves its worth again. Newer ones like Lp(a) and sVCAM-1 show promise. Add them to routine checks for early AF flags. This guides prevention and cuts events. Large trials must confirm their fit in practice.