Use of Biomarkers to Predict Specific Causes of Death in Patients With Atrial Fibrillation

Sharma, Abhinav; Hijazi, Ziad; Andersson, Ulrika; Al‐Khatib, Sana M.; Lópes, Renato D.; Alexander, John H.; Held, Claes; Leonardi, Sergio; Hanna, Michael; Siegbahn, Agneta; Granger, Christopher B.; Wallentin, Lars

doi:10.1161/circulationaha.118.034125

Cited by 36 publications

(28 citation statements)

References 35 publications

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“…To date, numerous publications have demonstrated a significant relationship between higher troponin values and worse prognosis in patients with acute myocardial infarction, heart failure or severe aortic valve disease [9][10][11][12][13]. It has also been described that TnT is a predictor of cardiac death in patients with CAD, atrial fibrillation or impaired left ventricular function [17][18][19][20][21]. However, Rahimi et al [22] did not show a significant correlation between postmortem TnT level and sudden death.…”

Section: Discussionmentioning

confidence: 99%

Postoperative high-sensitivity troponin T as a predictor of sudden cardiac arrest in patients undergoing cardiac surgery

et al. 2020

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Background: The usefulness of high-sensitivity troponin T (hs-TnT) as a predictor of sudden cardiac arrest (SCA) in patients undergoing valve surgery is currently unknown. Methods: A prospective study was conducted on a group of 815 consecutive patients with significant valvular heart disease that underwent elective valve surgery. The primary end-point was postoperative SCA. Results: The postoperative SCA occurred in 26 patients. At multivariate analysis of hs-TnT measured immediately after surgery (hs-TnT I) and age remained independent predictors of the primary end-point. Conclusions: Elevated postoperative hs-TnT was associated with a higher risk of postoperative SCA. (Cardiol J 2019; 26, 6: 777-781)

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Section: Discussionmentioning

confidence: 99%

Postoperative high-sensitivity troponin T as a predictor of sudden cardiac arrest in patients undergoing cardiac surgery

et al. 2020

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“…Predicting the occurrence of events throughout the follow‐up using models that incorporated biomarkers has been attempted in patients with atrial fibrillation enrolled in the ARISTOTLE trial . In this analysis, hsTnT and NT‐proBNP were strongly associated with CV death; however, non‐CV death was not assessed and whether these biomarkers could differentiate the modes of death was not determined.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular and non‐cardiovascular death distinction: the utility of troponin beyond N‐terminal pro‐B‐type natriuretic peptide. Findings from the BIOSTAT‐CHF study

Ferreira

Ouwerkerk

Tromp

et al. 2019

European J of Heart Fail

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AimsHeart failure (HF) patients are at high-risk of cardiovascular (CV) events, including CV death. Nonetheless, a substantial proportion of these patients die from non-CV causes. Identifying patients at higher risk for each individual event may help selecting patients for clinical trials and tailoring cardiovascular therapies. The aims of the present study are to: (i) characterize patients according to CV vs. non-CV death; (ii) develop models for the prediction of the respective events; (iii) assess the models' performance to differentiate CV from non-CV death.This study included 2309 patients with HF from the BIOSTAT-CHF (a systems BIOlogy Study to TAilored Treatment in Chronic Heart Failure) study. Competing-risk models were used to assess the best combination of variables associated with each cause-specific death. Results were validated in an independent cohort of 1738 HF patients. The best model to predict CV death included low blood pressure, estimated glomerular filtration rate ≤ 60 mL/min, peripheral oedema, previous HF hospitalization, ischaemic HF, chronic obstructive pulmonary disease, elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP), and troponin (c-index = 0.73). The non-CV death model incorporated age > 75 years, anaemia and elevated NT-proBNP (c-index = 0.71). Both CV and non-CV death rose by quintiles of the risk scores; yet these models allowed the identification of patients in whom absolute CV death rates clearly outweigh non-CV death ones. These findings were externally replicated, but performed worse in a less severely diseased population. ConclusionsRisk models for predicting CV and non-CV death allowed the identification of patients at higher absolute risk of dying from CV causes (vs. non-CV ones). Troponin helped in predicting CV death only, whereas NT-proBNP helped in the prediction of both CV and non-CV death. These findings can be useful both for tailoring therapies and for patient selection in HF trials in order to attain CV event enrichment.

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“…The predictive value of GDF-15 in ACS has been con rmed in the 2 large non-ST-segment-elevation ACS (NSTE-ACS) trials: the GUSTO-IV (Global Utilization of Strategies to Open Occluded Arteries IV) and FRISC II (Fast Revascularization during Instability in Coronary Artery Disease II) cohorts [12,15]. Sharma A reported in the ARISTOTLE trial which included 18 201 patients with atrial brillation that GDF-15 was the strongest marker associated with bleeding death [37]. According to Bouabdallaoui N 's research baseline GDF-15 and changes of GDF-15 at both 1 month and 8 months were associated with subsequent mortality and CV events in patients with heart failure in the PARADIGM-HF trial [38].…”

Section: Gdf-15 and Cardiac Outcomesmentioning

confidence: 99%

“…The prognostic value of GDF-15 has been reported for various cardiovascular diseases, such as ACS, atrial brillation, and heart failure [12,14,15,37,38]. Lindholm had reported a study included 17 095 patients with acute coronary syndrome, GDF-15 was the strongest marker associated with all-cause death [14].…”

Section: Gdf-15 and Cardiac Outcomesmentioning

confidence: 99%

Growth differentiation factor 15 is associated with cardiovascular outcomes in patients with coronary artery disease

Duan

Cai

et al. 2020

Preprint

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Abstract Background: Growth differentiation factor-15 (GDF-15) is a marker of inflammation, oxidative stress and it is associated with adverse prognosis in cardiovascular disease. The aim of the present cohort study is to investigate the prognostic value of GDF-15 in patients with coronary artery disease (CAD) during long-term follow up.Methods: A total of 3641 consecutive patients with CAD were prospectively enrolled into the study and followed up for major adverse cardiovascular events (MACEs) and all-cause death up to 5.3-7.6 years. Plasma GDF-15 was measured and clinical data and long-term events were registered. The patients were subsequently divided into three groups by the levels of GDF-15 and the prognostic value of GDF-15 level with MACEs and all-cause death was evaluated.Results: After a median follow-up at 6.4 years later, 775 patients (event rate of 21%) had developed MACEs and 275 patients died (event rate of 7.55%). Kaplan–Meier analysis indicated that the patients with GDF-15 > 1800 ng/L were significantly associated with an increased risk of MACEs and all-cause death. Cox regression analysis indicated that GDF-15 > 1800 ng/L were independently associated with the composite of MACEs (HR 1.74; 95% CI: 1.44–2.02; P＜0.001) and all-cause death (HR 2.04; 95% CI 1.57–2.61; P＜0.001). For MACEs, GDF-15 significantly improved the C-statistic (area under the curve, 0.583 [95% CI, 0.559-0.606] to 0.628 [0.605-0.651]; P＜0.001), net reclassification index (0.578; P=0.031), and integrated discrimination index (0.021; P=0.027). For all-cause death, GDF-15 significantly improved the C-statistic (0.728 [95% CI, 0.694-0.761] to 0.817 [0.781-0.846]; P＜0.001), net reclassification index (0.629; P=0.001), and integrated discrimination index (0.035; P=0.002).Conclusions: In the setting of CAD, GDF-15 is associated with long-term MACEs and all-cause death, and provides incremental prognostic value beyond traditional risks factors.

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Use of Biomarkers to Predict Specific Causes of Death in Patients With Atrial Fibrillation

Abstract: URL: https://www.clinicaltrials.gov . Unique identifier: NCT00412984.

Cited by 36 publications

References 35 publications

Postoperative high-sensitivity troponin T as a predictor of sudden cardiac arrest in patients undergoing cardiac surgery

Postoperative high-sensitivity troponin T as a predictor of sudden cardiac arrest in patients undergoing cardiac surgery

Cardiovascular and non‐cardiovascular death distinction: the utility of troponin beyond N‐terminal pro‐B‐type natriuretic peptide. Findings from the BIOSTAT‐CHF study

Growth differentiation factor 15 is associated with cardiovascular outcomes in patients with coronary artery disease

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