{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T22:47:04Z","timestamp":1782514024256,"version":"3.54.5"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,7,30]],"date-time":"2021-07-30T00:00:00Z","timestamp":1627603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002996","name":"Dutch Heart Foundation","doi-asserted-by":"crossref","award":["NHS2010B233"],"award-info":[{"award-number":["NHS2010B233"]}],"id":[{"id":"10.13039\/501100002996","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>The clinical risk profile of atrial fibrillation (AF) patients is different in men and women. Our aim was to identify sex differences in blood biomarkers in patients with paroxysmal AF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Sex differences in 92 blood biomarkers were measured in 364 patients included in our discovery cohort, the identification of a risk profile to guide atrial fibrillation therapy (AF-RISK) study, assessed by multivariable logistic regression and enrichment pathway analysis. Findings were subsequently confirmed in 213 patients included in our validation cohort, the Reappraisal of Atrial Fibrillation: Interaction between HyperCoagulability, Electrical remodelling, and Vascular Destabilisation in the Progression of AF (RACE V) study. In the discovery cohort, mean age was 59\u2009\u00b1\u200912\u2009years, 41% were women. CHA2DS2-VASc-score was 1.6\u2009\u00b1\u20091.4. A total of 46% had hypertension, 10% diabetes, and 50% had heart failure, predominantly with preserved ejection fraction (47%). In women, activated leucocyte cell adhesion molecule (ALCAM) and fatty acid binding protein-4 (FABP-4) were higher. In men, matrix metalloproteinase-3 (MMP-3), C-C motif chemokine-16 (CCL-16), and myoglobin were higher. In the validation cohort, four out of five biomarkers could be confirmed: levels of ALCAM (P\u2009=\u20091.73 \u00d7 10\u20134) and FABP-4 (P\u2009=\u20092.46 \u00d7 10\u20137) and adhesion biological pathways [false discovery rate (FDR)\u2009=\u20091.23 \u00d7 10\u20138] were higher in women. In men, levels of MMP-3 (P\u2009=\u20094.31 \u00d7 10\u20138) and myoglobin (P\u2009=\u20092.10 \u00d7 10\u20134) and markers for extracellular matrix degradation biological pathways (FDR\u2009=\u20093.59 \u00d7 10\u20139) were higher.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In women with paroxysmal AF, inflammatory biomarkers were more often higher, while in men with paroxysmal AF, biomarkers for vascular remodelling were higher. Our data support the clinical notion that pathophysiological mechanisms in women and men with AF may differ.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration<\/jats:title>\n                  <jats:p>Clinicaltrials.gov identifier NCT01510210 for AF-RISK; Clinicaltrials.gov NCT02726698 for RACE V.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euab179","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T19:08:08Z","timestamp":1624993688000},"page":"193-201","source":"Crossref","is-referenced-by-count":12,"title":["Different circulating biomarkers in women and men with paroxysmal atrial fibrillation: results from the AF-RISK and RACE V studies"],"prefix":"10.1093","volume":"24","author":[{"given":"Ruben R","family":"De With","sequence":"first","affiliation":[{"name":"Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, Hanzeplein 1, 9713 GZ, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3043-1675","authenticated-orcid":false,"given":"Vicente","family":"Artola Arita","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, Hanzeplein 1, 9713 GZ, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bao-Oanh","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, Hanzeplein 1, 9713 GZ, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Linz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre+, Maastricht, The Netherlands"},{"name":"Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands"},{"name":"Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands"},{"name":"Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia"},{"name":"Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7796-4463","authenticated-orcid":false,"given":"Hugo","family":"Ten Cate","sequence":"additional","affiliation":[{"name":"Departments of Biochemistry, Thrombosis Expertise Center (TEC) Maastricht, Maastricht, The Netherlands"},{"name":"Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands"},{"name":"Maastricht University Medical Center+, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henri","family":"Spronk","sequence":"additional","affiliation":[{"name":"Departments of Biochemistry, Thrombosis Expertise Center (TEC) Maastricht, Maastricht, The Netherlands"},{"name":"Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands"},{"name":"Maastricht University Medical Center+, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Schotten","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands"},{"name":"Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Jan van Zonneveld","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine (Nephrology), Einthoven Laboratory for Vascular and Regenerative Medicine, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6mer","family":"Erk\u00fcner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre+, Maastricht, The Netherlands"},{"name":"Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Agustina","family":"Bay\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, Hanzeplein 1, 9713 GZ, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders S","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Randers Regional Hospital, Randers, Denmark"},{"name":"Centre for Emergency Medicine, Institute for Clinical Medicine, Aarhus University, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin G L M","family":"Luermans","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre+, Maastricht, The Netherlands"},{"name":"Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1073-5337","authenticated-orcid":false,"given":"Harry J G M","family":"Crijns","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre+, Maastricht, The Netherlands"},{"name":"Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle C","family":"Van 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