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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Use of Biomarkers to Predict Specific Causes of Death in Patients With Atrial Fibrillation

Abhinav Sharma1, Ziad Hijazi2, Ulrika Andersson2

  • 1Duke Clinical Research Institute, Duke University, Durham, NC (A.S., S.M.A.-K., R.D.L., J.H.A., C.B.G.).

Circulation
|June 7, 2018
PubMed

Insights

Biomarkers like troponin T and NT-proBNP strongly predict specific causes of death in atrial fibrillation patients. These findings may help identify high-risk individuals for targeted interventions.

Area of Science:

  • Cardiology
  • Biomarker Research
  • Clinical Trials

Background:

  • Atrial fibrillation increases mortality risk.
  • Established biomarkers predict cardiovascular events and death in anticoagulated AF patients.
  • Prognostic value of these biomarkers for specific causes of death remains unclear.

Purpose of the Study:

  • To investigate the prognostic utility of high-sensitivity troponin T, growth differentiation factor-15, NT-proBNP, and interleukin-6 for cause-specific death in anticoagulated atrial fibrillation patients.
  • To determine if these biomarkers can improve risk stratification for different causes of death.

Main Methods:

  • Analysis of data from 14,798 patients in the ARISTOTLE trial (apixaban vs. warfarin for AF).
  • Biomarkers measured at randomization; median follow-up of 1.9 years.
  • Cox models used to identify independent predictors of cause-specific mortality.

Main Results:

  • Biomarkers were strong predictors of cause-specific death.
  • Troponin T strongly predicted sudden death (HR 1.48) and stroke/systemic embolism death (HR 1.45).
  • NT-proBNP predicted heart failure death (HR 1.62), and growth differentiation factor-15 predicted bleeding death (HR 1.72).
  • Adding biomarkers to clinical variables improved risk discrimination for all cause-specific deaths.

Conclusions:

  • Biomarkers are potent predictors of cause-specific mortality in anticoagulated atrial fibrillation patients.
  • These biomarkers may enhance risk assessment, aiding in the identification of patients prone to specific fatal outcomes.
  • Further research could leverage these biomarkers for personalized risk management in atrial fibrillation.
Abstract

Keywords:
atrial fibrillationbiomarkerscause of deathprediction

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