Scientists from the University of Navarra, at partnership with clinicians from the Hospital Universitario de Donostia, have identified two biomarkers associated with the risk of suffering atrial fibrillation, a heart condition that affects more than 33.5 million people worldwide. In the European Union it is present in 8.8 million people over 55 years of age and, specifically in Spain, more than 4% of the population over 40 years of age suffers from it. The World Health Organization considers this disease to be an epidemic due to its high morbidity and mortality, and a public health problem due to its high prevalence.

Atrial fibrillation is the most common heart rhythm disturbance (arrhythmia). It occurs when the heart pumps blood in an accelerated and irregular manner, thus increasing the risk of suffering a heart attack, heart failure, stroke or other complications associated with this organ. Some of the most common causes are hypertension, various heart diseases or hormonal alterations. It can be treated with medications and procedures, such as cardiac ablation, to correct the irregular heart rhythm.

Researchers from the Cimaof the Clínica Universidad de Navarra and the School of Sciences, have discovered that a blood test can predict the onset of this cardiac ailment. "The alteration of three molecules related to collagen metabolism (CITP, MMP-1 and PICP) determine the risk of suffering atrial fibrillation and the response to its treatment", explains Dr. Javier Díez, director of the Cardiovascular Diseases Program of the Cima, head of research of the department of Cardiology and co-director of the department of Nephrology of the Clínica Universidad de Navarra.

Advances towards precision medicine

The study was conducted in 392 patients, 150 of whom were treated by cardiac ablation. "We have found that patients with low CITP/MMP-1 ratio and high PICP levels are at high risk of developing atrial fibrillation and of recurrence after cardiac ablation. Confirmation of these findings can lay the groundwork instructions to precisely adjust the most optimal treatment and follow-up for each patient according to these biomarkers," adds Dr. Díez, who also belongs to the CIBERCV.

This research, led by Dr. Díez and Dr. Ignacio García-Bolao, director of the department of Cardiology and Cardiac Surgery of the Clínica Universidad de Navarra, has been published in the prestigious scientific journal Journal of the American College of Cardiology. The same issue of this manuscript offers a publishing house that highlights the scientific advance that this study represents towards precision medicine. 

• reference letter bibliographic:
  Combination of Circulating Type I Collagen-Related Biomarkers Is Associated With Atrial Fibrillation.
  ​DOI: 10.1016/j.jacc.2018.12.074