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Bohm A, Snopek P, Tothova L, Bezak B, Jajcay N, Vachalcova M, Uher T, Kurecko M, Kissova V, Danova K, Olejnik P, Michalek P, Hlavata T, Petrikova K, Mojto V, Kyselovic J, Farsky S. Association Between Apelin and Atrial Fibrillation in Patients With High Risk of Ischemic Stroke. Front Cardiovasc Med 2021; 8:742601. [PMID: 34712712 PMCID: PMC8545982 DOI: 10.3389/fcvm.2021.742601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/13/2021] [Indexed: 01/29/2023] Open
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.
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Affiliation(s)
- Allan Bohm
- National Institute of Cardiovascular Diseases, Bratislava, Slovakia.,3rd Department of Internal Medicine, Faculty of Medicine, Comenius University in Bratislava, University Hospital Bratislava, Bratislava, Slovakia.,Premedix Academy, Bratislava, Slovakia
| | - Peter Snopek
- Department of Cardiology, Faculty Hospital Nitra, Nitra, Slovakia.,St. Elizabeth University of Health and Social Work in Bratislava, Bratislava, Slovakia
| | - Lubomira Tothova
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia.,Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Branislav Bezak
- National Institute of Cardiovascular Diseases, Bratislava, Slovakia.,Faculty of Medicine, Comenius University, Bratislava, Slovakia.,Faculty of Medicine, Slovak Medical University in Bratislava, Bratislava, Slovakia
| | - Nikola Jajcay
- Premedix Academy, Bratislava, Slovakia.,Department of Complex Systems, Institute of Computer Science, Czech Academy of Sciences, Prague, Czechia
| | - Marianna Vachalcova
- 1st Department of Cardiology, East Slovak Institute of Cardiovascular Diseases, Košice, Slovakia.,Faculty of Medicine, Pavol Jozef Safarik University, Košice, Slovakia
| | | | - Marian Kurecko
- 1st Department of Cardiology, East Slovak Institute of Cardiovascular Diseases, Košice, Slovakia
| | - Viera Kissova
- 1st Department of Internal Medicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Katarina Danova
- Department of Laboratory Medicine, National Institute of Cardiovascular Diseases, Bratislava, Slovakia
| | - Peter Olejnik
- National Institute of Cardiovascular Diseases, Bratislava, Slovakia.,Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | | | - Tereza Hlavata
- 3rd Department of Internal Medicine, Faculty of Medicine, Comenius University in Bratislava, University Hospital Bratislava, Bratislava, Slovakia.,Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | | | - Viliam Mojto
- 3rd Department of Internal Medicine, Faculty of Medicine, Comenius University in Bratislava, University Hospital Bratislava, Bratislava, Slovakia
| | - Jan Kyselovic
- Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Stefan Farsky
- House of the Heart (Dom Srdca), Slovak League Against Hypertension, Martin, Slovakia
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