The ABC (age, biomarkers, clinical history) stroke risk score: a biomarker-based risk score for predicting stroke in...

Area of Science:

• Cardiology
• Biomarkers in cardiovascular disease

Background:

• Atrial fibrillation (AF) significantly increases stroke risk, currently assessed using clinical factors.
• Cardiac biomarkers like NT-proBNP and cTn-hs are independently linked to stroke risk in AF patients.

Purpose of the Study:

• To develop and validate a novel biomarker-based risk score for enhanced stroke prognostication in AF.
• To improve upon existing clinical risk assessment tools for AF-related stroke.

Main Methods:

• Developed and validated the ABC-stroke score using Cox-regression in large AF cohorts (n=14,701 and n=1,400).
• Included age, NT-proBNP, cTn-hs, and prior stroke/TIA in the score.
• Assessed predictive performance using c-indices and calibration.

Main Results:

• The ABC-stroke score demonstrated superior predictive accuracy (higher c-indices) compared to CHA2DS2-VASc in both derivation and validation cohorts.
• Key predictors identified were prior stroke/TIA, NT-proBNP, cTn-hs, and age.
• The score showed consistent performance across various patient subgroups.

Conclusions:

• A novel, validated biomarker-based risk score (ABC-stroke) effectively predicts stroke in AF patients.
• The ABC-stroke score outperforms the CHA2DS2-VASc score, offering improved clinical decision support for stroke prevention in AF.