Neurofilament Levels Linked to AF Risk

Higher levels associated with stroke, death, and heart failure in long-term cohort

By
Andrea Surnit
March 30, 2026
3 min

Conexiant

Objective:

To investigate the association between serum neurofilament light chain (NfL) levels and the risk of major vascular events and mortality in patients with atrial fibrillation (AF).

Approach:

Key Findings:

Each doubling of serum NfL levels was associated with a 35% higher risk of major vascular events.
Incidence of major vascular events rose from 14% in the lowest NfL quartile to 55% in the highest.
Doubling NfL levels linked to a 31% higher risk of nonfatal stroke, 36% higher risk of cardiovascular death, 25% higher risk of heart failure-related hospitalization, and 41% higher risk of all-cause mortality.
No significant association found with myocardial infarction.

Interpretation:

Serum NfL may serve as a noncardiac biomarker to identify AF patients at higher risk for adverse cardiovascular outcomes.

Limitations:

Observational study design limits causal inference.
Conducted exclusively in Switzerland, potentially limiting generalizability.

Conclusion:

Higher serum NfL levels correlate with increased risks of major vascular events and mortality in AF patients, suggesting its utility in risk stratification.