Simple Blood Test Can Identify People with Higher Risk of Stroke

Atrial fibrillation is the most prevalent cardiac arrhythmia, affecting approximately one-third of all individuals at some point in their lives. It is a common cause of stroke because it increases the risk of blood clots forming in the heart’s atria. Consequently, many individuals with atrial fibrillation receive anticoagulation therapy to prevent strokes. However, due to the heightened risk of serious hemorrhages from anticoagulation, only those with a moderate or high stroke risk are treated, not everyone with the condition. Therefore, accurately identifying those who would benefit from anticoagulation is crucial. While blood tests are routinely used in healthcare to assess organ function, including the heart, kidneys, and liver, no standard blood test exists to evaluate brain health in relation to cardiovascular disease. Researchers have now shown that a simple blood test reflecting brain health can determine which individuals are at increased stroke risk. This breakthrough could lead to more personalized treatment for patients with atrial fibrillation.

Researchers at Uppsala University (Uppsala, Sweden) studied the neurofilament protein, which is released from the brain under stress or low oxygen conditions, in blood samples from over 3000 individuals with atrial fibrillation. They monitored these individuals for an average of 18 months. Those with the highest levels of neurofilament in their blood were found to face the highest stroke risk. According to findings published in the journal Circulation, the risk of stroke for the quarter with the highest neurofilament levels was more than triple that of those with the lowest levels. Adding neurofilament measurements to standard cardiac blood tests from the same patients further improved stroke prediction. The next research steps will explore how various healthcare treatments affect neurofilament levels and whether this impacts the risk of stroke or death.

“We hope to be able to intervene at an earlier stage and inhibit injurious strain on the brain before it gives rise to symptoms,” said Julia Aulin, a cardiologist at Uppsala University Hospital and researcher at Uppsala University, the lead author of the study. “The findings are probably transferrable to other groups of patients with cardiovascular-related disorders, though this remains to be demonstrated. Our hope is that it will ultimately be possible to assess brain health with a simple blood test at the local health center.”

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