GDF-15 and risk stratification in atrial fibrillation

Marı́n, Francisco; Roldán, Vanessa

doi:10.1038/nrcardio.2014.190

Cited by 18 publications

(11 citation statements)

References 11 publications

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“…A number of biomarkers have been implied to be associated with cardiac fibrosis. A study [ 12 ] evaluating the association between extracellular matrix regulatory factors and AF risk showed that increased tissue inhibitors of metalloproteinases (TIMP) levels were significantly associated with AF risk. Growth differentiation factor (GDF-15) is a tumor growth factor-β family member.…”

Section: Introductionmentioning

confidence: 99%

Serum-Soluble ST2 Is a Novel Biomarker for Evaluating Left Atrial Low-Voltage Zone in Paroxysmal Atrial Fibrillation

et al. 2020

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Section: Introductionmentioning

confidence: 99%

Serum-Soluble ST2 Is a Novel Biomarker for Evaluating Left Atrial Low-Voltage Zone in Paroxysmal Atrial Fibrillation

et al. 2020

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“…Similarly, interleukin 6 has been demonstrated to be related to mortality, thromboembolic events, and major bleeding in patients with AF, while C‐reactive protein was associated with myocardial infarction . In the ARISTOTLE biomarker substudy (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation), a high level of growth differentiation factor 15, a member of the transforming growth factor‐β cytokine family, was an independent risk factor for major bleeding, mortality, and stroke in patients with AF …”

Section: Discussionmentioning

confidence: 99%

Long‐Term Stroke Risk Prediction in Patients With Atrial Fibrillation: Comparison of the ABC‐Stroke and CHA ₂ DS ₂ ‐VASc Scores

Rivera‐Caravaca

Roldán

Esteve‐Pastor

et al. 2017

JAHA

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BackgroundThe ABC‐stroke score (age, biomarkers [N‐terminal fragment B‐type natriuretic peptide, high‐sensitivity troponin], and clinical history [prior stroke/transient ischemic attack]) was proposed to predict stroke in atrial fibrillation (AF). This score was derived/validated in 2 clinical trial cohorts in which patients with AF were highly selected and carefully followed‐up. However, the median follow‐up was 1.9 years in the trial cohort; therefore, its long‐term predictive performance remains uncertain. This study aimed to compare the long‐term predictive performances of the ABC‐stroke and CHA 2 DS 2‐VASc (cardiac failure or dysfunction, hypertension, age ≥75 [doubled], diabetes mellitus, stroke [doubled]—vascular disease, age 65 to 74 years and sex category [female]) scores in a cohort of anticoagulated patients with AF.Methods and ResultsWe recruited 1125 consecutive patients with AF who were stable on vitamin K antagonists and followed‐up for a median of 6.5 years. ABC‐stroke and CHA 2 DS 2‐VASc (cardiac failure or dysfunction, hypertension, age ≥75 [doubled], diabetes mellitus, stroke [doubled]—vascular disease, age 65 to 74 years and sex category [female]) scores were calculated and compared. Median CHA 2 DS 2‐VASc and ABC‐stroke scores were 4 (interquartile range 3–5) and 9.1 (interquartile range 7.3–11.3), respectively. There were 114 ischemic strokes (1.55% per year) at 6.5 years. The C‐index of ABC‐stroke at 3.5 years was significantly higher than CHA 2 DS 2‐VASc (0.663 versus 0.600, P=0.046), but both C‐indexes were nonsignificantly different at 6.5 years. Integrated discrimination improvement showed a small improvement (<2%) in sensitivity at 3.5 and 6.5 years with ABC‐stroke. For ABC‐stroke, net reclassification improvement was nonsignificantly different at 3.5 years, and showed a negative reclassification at 6.5 years compared with CHA 2 DS 2‐VASc. Decision curve analyses did not show a marked improvement in clinical usefulness of the ABC‐stroke score over the CHA 2 DS 2‐VASc score.ConclusionsIn anticoagulated patients with AF followed‐up over a long‐term period, the novel ABC‐stroke score does not offer significantly better predictive performance compared with the CHA 2 DS 2‐VASc score.

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“…Risk scores in patients with AF based on clinical factors alone generally have only modest predictive value for predicting high risk patients that develop events (with c-indexes approximately 0.60-0.65). Due to the limited capacity of clinical risk scores, the use of biomarkers might be an attractive prognostic tool to improve on clinical risk stratification (7), as highlighted over a decade ago (8).…”

Section: Introductionmentioning

confidence: 99%

Long-term bleeding risk prediction in ‘real world’ patients with atrial fibrillation: Comparison of the HAS-BLED and ABC-Bleeding risk scores

Esteve-Pastor¹,

Rivera‐Caravaca²,

Roldán³

et al. 2017

Thromb Haemost

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Risk scores in patients with atrial fibrillation (AF) based on clinical factors alone generally have only modest predictive value for predicting high risk patients that sustain events. Biomarkers might be an attractive prognostic tool to improve bleeding risk prediction. The new ABC-Bleeding score performed better than HAS-BLED score in a clinical trial cohort but has not been externally validated. The aim of this study was to analyze the predictive performance of the ABC-Bleeding score compared to HAS-BLED score in an independent "real-world" anticoagulated AF patients with long-term follow-up. We enrolled 1,120 patients stable on vitamin K antagonist treatment. The HAS-BLED and ABC-Bleeding scores were quantified. Predictive values were compared by c-indexes, IDI, NRI, as well as decision curve analysis (DCA). Median HAS-BLED score was 2 (IQR 2-3) and median ABC-Bleeding was 16.5 (IQR 14.3-18.6). After 6.5 years of follow-up, 207 (2.84 %/year) patients had major bleeding events, of which 65 (0.89 %/year) had intracranial haemorrhage (ICH) and 85 (1.17 %/year) had gastrointestinal bleeding events (GIB). The c-index of HAS-BLED was significantly higher than ABC-Bleeding for major bleeding (0.583 vs 0.518; p=0.025), GIB (0.596 vs 0.519; p=0.017) and for the composite of ICH-GIB (0.593 vs 0.527; p=0.030). NRI showed a significant negative reclassification for major bleeding and for the composite of ICH-GIB with the ABC-Bleeding score compared to HAS-BLED. Using DCAs, the use of HAS-BLED score gave an approximate net benefit of 4 % over the ABC-Bleeding score. In conclusion, in the first "real-world" validation of the ABC-Bleeding score, HAS-BLED performed significantly better than the ABC-Bleeding score in predicting major bleeding, GIB and the composite of GIB and ICH.

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GDF-15 and risk stratification in atrial fibrillation

Cited by 18 publications

References 11 publications

Serum-Soluble ST2 Is a Novel Biomarker for Evaluating Left Atrial Low-Voltage Zone in Paroxysmal Atrial Fibrillation

Serum-Soluble ST2 Is a Novel Biomarker for Evaluating Left Atrial Low-Voltage Zone in Paroxysmal Atrial Fibrillation

Long‐Term Stroke Risk Prediction in Patients With Atrial Fibrillation: Comparison of the ABC‐Stroke and CHA ₂ DS ₂ ‐VASc Scores

Long-term bleeding risk prediction in ‘real world’ patients with atrial fibrillation: Comparison of the HAS-BLED and ABC-Bleeding risk scores

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GDF-15 and risk stratification in atrial fibrillation

Cited by 18 publications

References 11 publications

Serum-Soluble ST2 Is a Novel Biomarker for Evaluating Left Atrial Low-Voltage Zone in Paroxysmal Atrial Fibrillation

Serum-Soluble ST2 Is a Novel Biomarker for Evaluating Left Atrial Low-Voltage Zone in Paroxysmal Atrial Fibrillation

Long‐Term Stroke Risk Prediction in Patients With Atrial Fibrillation: Comparison of the ABC‐Stroke and CHA 2 DS 2 ‐VASc Scores

Long-term bleeding risk prediction in ‘real world’ patients with atrial fibrillation: Comparison of the HAS-BLED and ABC-Bleeding risk scores

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Long‐Term Stroke Risk Prediction in Patients With Atrial Fibrillation: Comparison of the ABC‐Stroke and CHA ₂ DS ₂ ‐VASc Scores