Biomarker identified to help predict atrial fibrillation in at-risk groups

Scientists have pinpointed two lipids — fats in the blood — that can help predict the development of a dangerous heart rhythm disorder, common in people with type 2 diabetes.

An estimated 15 per cent of people with type 2 diabetes have atrial fibrillation (AF) a rhythm disorder that commonly causes poor blood flow and dramatically increases the risk of heart attack, stroke and heart failure. Yet the condition is difficult to diagnose and treat, and there is an urgent need for an early detection tool.

By pinpointing lipids associated with AF in humans for the first time, researchers from the Baker Heart and Diabetes Institute’s Cardiac Hypertrophy and Metabolomics laboratories, led by Associate Professor Julie McMullen and Professor Peter Meikle, have shown a simple blood test could help identify risk.

In a study published in Diabetes, the researchers looked at plasma samples collected from 3772 Australians with type 2 diabetes, examining 316 different lipids in each sample.

They found two lipids associated with an improved ability to predict those in the study who would go on to develop AF, beyond traditional risk factors such as age, weight and blood pressure. They also found three lipids that could help identify those who already had AF.

AF is considered one of the new epidemics of cardiovascular disease. It is projected to increase by 60 per cent over the next 15 years , and there is particular concern for at-risk populations like those with type 2 diabetes.

Lead researcher Dr Yow Keat Tham said the condition was quite hard to detect and is easily missed because it is intermittent, especially in the early stages.

“Having a biomarker like this would help clinicians cast the net wider in pinpointing who is at risk and where further action may be required,” Dr Tham said.

“This will help pick up people who have been overlooked in the past or haven’t had the condition identified for a number of years. A delay in detection leaves AF to progress to a much more serious stage, which means a significantly higher risk of heart attack and stroke, and it pushes the heart towards heart failure.

“There isn’t a cure for AF, but if it’s detected earlier you can treat the symptoms earlier and improve people’s outcomes. So anything that can help clinicians identify when they need to intervene to help slow the progression of disease is very helpful.”

With a growing number of people living with type 2 diabetes in Australia — currently 1.2 million are diagnosed with the disease — finding ways to better predict its costly and potentially deadly complications is critical.

Alfred Health cardiologist Dr Aleksandr Voskoboinik, who recently completed a PhD in the Baker Institute’s Clinical Electrophysiology lab, said being able to better predict which patients will develop AF would enable them to start interventions, particularly blood thinning medication, before it was too late.

“We see many patients, particularly in an older age group, who have various cardiovascular risk factors, such as diabetes, and we know many of them will eventually develop AF. Sadly, the first presentation for some of these patients is a devastating stroke,” Dr Voskoboinik said.

“This would affect potentially millions of Australians, and if you could predict future AF and treat it earlier that could save many lives.”

/Baker Institute Public Release. View in full here.