Plasma NfL levels associated with cardiovascular risk

Elevated levels of neurofilament light chain (NfL) are a known biomarker for neurodegeneration in conditions such as stroke, dementia, multiple sclerosis, and amyotrophic lateral sclerosis. A new study revealed that NfL may also be a risk marker for the onset of cardiac disease. Circulating NfL levels were found to be associated with future risk of all cardiovascular diseases, coronary heart disease, and heart failure, but only in minimally adjusted models.

To determine whether NfL is a risk marker for future cardiovascular disease, Dr Hugo Aparicio (Boston University School of Medicine, MA, USA) and colleagues determined plasma NfL levels of 2,048 participants in the community-based Framingham Heart Study Offspring and OMNI1 cohorts using a high-sensitivity, single-molecule array [1]. Mean age was 69 years, and 58% were women. All models were adjusted for age, sex, and cohort.

During the study period (2011–2019), 175 (8.5%) incident cardiovascular events were observed. With a mean 5.5 years of follow-up, baseline NfL levels were related to the incidence of cardiovascular disease and its individual components. Higher plasma NfL levels were associated with an increased risk of:

• coronary heart disease (n=67; HR 1.56; 95% CI 1.00–2.41);


• heart failure (n=91; HR 1.67; 95% CI 1.13–2.47);


• cardiovascular disease (HR 1.43; 95% CI 1.05-1.95)

However, no association was found between higher plasma NfL level and stroke (n=60; HR 1.00; 95% CI 0.56–1.78).

These associations were no longer significant after further adjusting the models for renal function, BMI, race, current smoking, diabetes, systolic blood pressure, anti-hypertensive treatment, and high-density lipoprotein level. The authors added that further research is needed to find out which of the adjusted risk factors attenuate the association between NfL and cardiac risk.

1. Aparicio H, et al. Association of Plasma NfL Levels with Risk of Cardiovascular Disease in the Framingham Heart Study. S33.005, AAN 2022, 02–07 April, Seattle, USA.

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Posted on 2 June, 2022