{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T05:30:33Z","timestamp":1788240633399,"version":"build-2803163510"},"reference-count":30,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Cardiol"],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"\n Importance<\/jats:title>\n Serum neurofilament light chain (sNfL) is a blood-based biomarker initially investigated for neuronal injury and is elevated in patients with atrial fibrillation (AF). Whether sNfL is associated with other adverse outcomes in this population is less well studied.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine the association between sNfL and cardiovascular outcomes in patients with AF.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n The Swiss Atrial Fibrillation Cohort (SWISS-AF) is a prospective, multicenter, observational cohort study. The present analysis included patients enrolled from April 2014 through August 2017, with follow-up until April 23, 2025. Data analysis was conducted in June 2025. SWISS-AF enrolled inpatients and outpatients across 14 secondary or tertiary care centers in Switzerland. This analysis included 2311 of 2415 (95.7%) patients with documented AF in SWISS-AF after the exclusion of 76 patients without sNfL measurements and 28 patients with missing follow-up data.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Concentrations of sNfL were measured from baseline serum samples using an ultrasensitive single-molecule array assay.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was major vascular events (MVEs), defined as a composite of cardiovascular death, nonfatal stroke, and nonfatal myocardial infarction. Other outcomes included the individual components of MVEs, heart failure\u2013related hospitalization, and all-cause mortality.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 2311 included patients, mean (SD) age was 73.2 (8.5) years, and 1683 (73%) were male. Over a median (IQR) follow-up of 8.0 (5.2-9.0) years, there were 665 first MVE events, corresponding to an incidence per 100 patient-years of 4.4 (95% CI, 4.1-4.8). Every doubling of sNfL concentration was associated with an adjusted hazard ratio (aHR) for MVEs of 1.35 (95% CI, 1.22-1.50;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). Increasing sNfL levels were associated with nonfatal stroke (aHR, 1.31; 95% CI, 1.09-1.57;\n P<\/jats:italic>\n \u2009=\u2009.004), cardiovascular death (aHR, 1.36; 95% CI, 1.20-1.54;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), heart failure\u2013related hospitalization (aHR, 1.25; 95% CI, 1.11-1.41;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), and all-cause mortality (aHR, 1.41; 95% CI, 1.27-1.56;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) but not myocardial infarction (aHR, 1.04; 95% CI, 0.81 to 1.34;\n P<\/jats:italic>\n \u2009=\u2009.76).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n After multivariable adjustment, sNfL levels were associated with a broad range of adverse cardiovascular events and mortality in patients with AF. Serum NfL may serve as a biomarker of cardiovascular risk in patients with AF.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamacardio.2026.0922","type":"journal-article","created":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T18:30:17Z","timestamp":1774809017000},"page":"400","source":"Crossref","is-referenced-by-count":6,"title":["Serum Neurofilament Light Chain and Cardiovascular Outcomes in Patients With Atrial Fibrillation"],"prefix":"10.1001","volume":"11","author":[{"given":"Geethan","family":"Baskaran","sequence":"first","affiliation":[{"name":"Population Health Research Institute, Hamilton, Ontario, Canada"},{"name":"Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Krisai","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland"},{"name":"Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"K\u00fchne","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland"},{"name":"Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Aeschbacher","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland"},{"name":"Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Kuhle","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, University Hospital and University of Basel, Basel, Switzerland"},{"name":"Research Center for Clinical Neuroimmunology and Neuroscience, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal B.","family":"Meyre","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, Hamilton, Ontario, Canada"},{"name":"Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland"},{"name":"Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Coslovsky","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, University Hospital and University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luisa","family":"De Perna","sequence":"additional","affiliation":[{"name":"Cardiology Department, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leo H.","family":"Bonati","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, University Hospital and University of Basel, Basel, Switzerland"},{"name":"Research Department, Reha Rheinfelden, Rheinfelden, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Ammann","sequence":"additional","affiliation":[{"name":"Hoch-Health Ostschweiz, St Gallen, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrg H.","family":"Beer","sequence":"additional","affiliation":[{"name":"Platelet Research Unit, Center of Molecular Cardiology, University of Zurich, Zurich, Switzerland"},{"name":"Thrombosis and Hemostasis Unit, Department of Medicine, Cantonal Hospital of Baden, Baden, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Moschovitis","sequence":"additional","affiliation":[{"name":"Cardiology Department, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Sinnecker","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Conte","sequence":"additional","affiliation":[{"name":"Cardiology Department, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland"},{"name":"Faculty of Biomedical Sciences, Universit\u00e0 della Svizzera Italiana, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Rodondi","sequence":"additional","affiliation":[{"name":"Institute of Primary Health Care, University of Bern, Bern, Switzerland"},{"name":"Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisavet","family":"Moutzouri","sequence":"additional","affiliation":[{"name":"Institute of Primary Health Care, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca E.","family":"Paladini","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland"},{"name":"Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Osswald","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Conen","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, Hamilton, Ontario, Canada"},{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"},{"name":"Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"20","key":"hoi260020r1","doi-asserted-by":"publisher","first-page":"2080","DOI":"10.1001\/jama.2011.659","article-title":"Risk of death and cardiovascular events in initially healthy women with new-onset atrial fibrillation.","volume":"305","author":"Conen","year":"2011","journal-title":"JAMA"},{"issue":"2","key":"hoi260020r2","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1007\/s10840-017-0308-9","article-title":"Atrial fibrillation is associated with sudden cardiac death: a systematic review and meta-analysis.","volume":"51","author":"Rattanawong","year":"2018","journal-title":"J Interv Card Electrophysiol"},{"key":"hoi260020r3","doi-asserted-by":"publisher","first-page":"i4482","DOI":"10.1136\/bmj.i4482","article-title":"Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: systematic review and meta-analysis.","volume":"354","author":"Odutayo","year":"2016","journal-title":"BMJ"},{"issue":"14","key":"hoi260020r4","doi-asserted-by":"publisher","first-page":"1555","DOI":"10.1177\/2047487317715769","article-title":"Atrial fibrillation and the risk for myocardial infarction, all-cause mortality and heart failure: a systematic review and meta-analysis.","volume":"24","author":"Ruddox","year":"2017","journal-title":"Eur J Prev Cardiol"},{"issue":"22","key":"hoi260020r5","doi-asserted-by":"publisher","first-page":"2127","DOI":"10.1093\/eurheartj\/ehac020","article-title":"Silent brain infarcts impact on cognitive function in atrial fibrillation.","volume":"43","author":"K\u00fchne","year":"2022","journal-title":"Eur Heart J"},{"issue":"1","key":"hoi260020r6","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1007\/s00418-013-1101-1","article-title":"Review on intermediate filaments of the nervous system and their pathological alterations.","volume":"140","author":"L\u00e9pinoux-Chambaud","year":"2013","journal-title":"Histochem Cell Biol"},{"issue":"10","key":"hoi260020r7","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1038\/s41582-018-0058-z","article-title":"Neurofilaments as biomarkers in neurological disorders.","volume":"14","author":"Khalil","year":"2018","journal-title":"Nat Rev Neurol"},{"issue":"14","key":"hoi260020r8","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.122.025910","article-title":"Serum neurofilament light chain in patients with atrial fibrillation.","volume":"11","author":"Sj\u00f6lin","year":"2022","journal-title":"J Am Heart Assoc"},{"issue":"2","key":"hoi260020r9","doi-asserted-by":"publisher","DOI":"10.1093\/braincomms\/fcaa166","article-title":"Serum neurofilament light in atrial fibrillation: clinical, neuroimaging and cognitive correlates.","volume":"2","author":"Polymeris","year":"2020","journal-title":"Brain Commun"},{"issue":"3","key":"hoi260020r10","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1080\/1354750X.2023.2172211","article-title":"Serum neurofilament light chain in functionally relevant coronary artery disease and adverse cardiovascular outcomes.","volume":"28","author":"Amrein","year":"2023","journal-title":"Biomarkers"},{"issue":"6","key":"hoi260020r11","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.1016\/j.jchf.2024.03.005","article-title":"Serum markers of neurodegeneration are strongly linked to heart failure severity and outcome.","volume":"12","author":"Wurm","year":"2024","journal-title":"JACC Heart Fail"},{"issue":"7","key":"hoi260020r12","doi-asserted-by":"publisher","first-page":"1669","DOI":"10.1161\/STROKEAHA.119.024941","article-title":"Serum NfL (neurofilament light chain) levels and incident stroke in adults with diabetes mellitus.","volume":"50","author":"Korley","year":"2019","journal-title":"Stroke"},{"issue":"101647039","key":"hoi260020r13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2022.104146","article-title":"Serum neurofilament light levels are predictive of all-cause mortality in late middle-aged individuals.","volume":"82","author":"Nguyen","year":"2022","journal-title":"EBioMedicine"},{"issue":"1","key":"hoi260020r14","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1111\/jgs.18632","article-title":"Serum total tau, neurofilament light, and glial fibrillary acidic protein are associated with mortality in a population study.","volume":"72","author":"Halloway","year":"2024","journal-title":"J Am Geriatr Soc"},{"issue":"7","key":"hoi260020r15","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.015343","article-title":"Characterization, pathogenesis, and clinical implications of inflammation-related atrial myopathy as an important cause of atrial fibrillation.","volume":"9","author":"Packer","year":"2020","journal-title":"J Am Heart Assoc"},{"issue":"20","key":"hoi260020r16","doi-asserted-by":"publisher","first-page":"2239","DOI":"10.1016\/j.jacc.2015.03.557","article-title":"Fibrotic atrial cardiomyopathy, atrial fibrillation, and thromboembolism: mechanistic links and clinical inferences.","volume":"65","author":"Hirsh","year":"2015","journal-title":"J Am Coll Cardiol"},{"issue":"2","key":"hoi260020r17","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.124.038860","article-title":"Neuroglial biomarkers for risk assessment of ischemic stroke and other cardiovascular events in patients with atrial fibrillation not receiving oral anticoagulation.","volume":"14","author":"Aulin","year":"2025","journal-title":"J Am Heart Assoc"},{"issue":"14","key":"hoi260020r18","doi-asserted-by":"publisher","first-page":"1090","DOI":"10.1161\/CIRCULATIONAHA.124.069440","article-title":"Neurofilament light chain and risk of stroke in patients with atrial fibrillation.","volume":"150","author":"Aulin","year":"2024","journal-title":"Circulation"},{"key":"hoi260020r19","doi-asserted-by":"publisher","DOI":"10.4414\/smw.2017.14467","article-title":"Design of the Swiss Atrial Fibrillation Cohort Study (Swiss-AF): structural brain damage and cognitive decline among patients with atrial fibrillation.","volume":"147","author":"Conen","year":"2017","journal-title":"Swiss Med Wkly"},{"issue":"9","key":"hoi260020r20","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1016\/j.jacc.2018.12.039","article-title":"Relationships of overt and silent brain lesions with cognitive function in patients with atrial fibrillation.","volume":"73","author":"Conen","year":"2019","journal-title":"J Am Coll Cardiol"},{"issue":"6","key":"hoi260020r21","doi-asserted-by":"publisher","first-page":"857","DOI":"10.1002\/ana.24954","article-title":"Serum neurofilament light: a biomarker of neuronal damage in multiple sclerosis.","volume":"81","author":"Disanto","year":"2017","journal-title":"Ann Neurol"},{"issue":"21","key":"hoi260020r22","doi-asserted-by":"publisher","first-page":"1457","DOI":"10.1161\/CIRCULATIONAHA.125.076725","article-title":"Biomarker-based ABC-AF risk scores for personalized treatment to reduce stroke or death in atrial fibrillation: a registry-based, multicenter, randomized, controlled study.","volume":"152","author":"Oldgren","year":"2025","journal-title":"Circulation"},{"issue":"11","key":"hoi260020r23","doi-asserted-by":"publisher","first-page":"1173","DOI":"10.1016\/j.jacc.2024.11.052","article-title":"Biomarker-based model for prediction of ischemic stroke in patients with atrial fibrillation.","volume":"85","author":"Wallentin","year":"2025","journal-title":"J Am Coll Cardiol"},{"issue":"24","key":"hoi260020r24","doi-asserted-by":"publisher","first-page":"25729","DOI":"10.18632\/aging.203790","article-title":"Factors influencing serum neurofilament light chain levels in normal aging.","volume":"13","author":"Koini","year":"2021","journal-title":"Aging (Albany NY)"},{"issue":"1","key":"hoi260020r25","doi-asserted-by":"publisher","first-page":"9072","DOI":"10.1038\/s41598-024-59530-5","article-title":"Serum neurofilament light chain and inflammatory cytokines as biomarkers for early detection of mild cognitive impairment.","volume":"14","author":"Jing","year":"2024","journal-title":"Sci Rep"},{"key":"hoi260020r26","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2024.1432401","article-title":"Association between systemic immune-inflammation index and serum neurofilament light chain: a population-based study from the NHANES (2013-2014).","volume":"15","author":"Liu","year":"2024","journal-title":"Front Neurol"},{"issue":"11","key":"hoi260020r27","doi-asserted-by":"publisher","first-page":"1513","DOI":"10.1161\/CIRCRESAHA.125.326237","article-title":"Heart-brain crosstalk in myocardial infarction: role of heart extracellular vesicles in neuroinflammation.","volume":"136","author":"Liao","year":"2025","journal-title":"Circ Res"},{"issue":"7","key":"hoi260020r28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacbts.2025.05.002","article-title":"Cardiac injury regulates neuroinflammation through extracellular vesicle-mediated heart-brain crosstalk.","volume":"10","author":"Li","year":"2025","journal-title":"JACC Basic Transl Sci"},{"issue":"4","key":"hoi260020r29","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.032744","article-title":"The ABC-Stroke Risk Score and effects of atrial fibrillation screening on stroke prevention: results from the randomized LOOP study.","volume":"13","author":"Xing","year":"2024","journal-title":"J Am Heart Assoc"},{"issue":"47","key":"hoi260020r30","doi-asserted-by":"publisher","first-page":"5177","DOI":"10.1093\/eurheartj\/ehaf550","article-title":"Atrial fibrillation and atherosclerosis cause different vascular brain lesions on magnetic resonance imaging.","volume":"46","author":"Stegmann","year":"2025","journal-title":"Eur Heart J"}],"container-title":["JAMA Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamacardiology\/articlepdf\/2847053\/jamacardiology_baskaran_2026_oi_260020_1778624844.95688.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T15:01:31Z","timestamp":1778684491000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamacardiology\/fullarticle\/2847053"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,1]]},"references-count":30,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamacardio.2026.0922","relation":{},"ISSN":["2380-6583"],"issn-type":[{"value":"2380-6583","type":"print"}],"subject":[],"published":{"date-parts":[[2026,5,1]]}}}