Relation between soluble ST2, growth differentiation factor-15, and high-sensitivity troponin I and incident atrial fibrillation

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• 作者：Michiel Rienstra ; Xiaoyan Yin ; Martin G. Larson ; Jo茫o D. Fontes ; Jared W. Magnani ; David D. McManus ; Elizabeth L. McCabe ; Erin E. Coglianese ; Michael Amponsah ; Jennifer E. Ho ; James L. Januzzi Jr. ; Kai C. Wollert ; Michael G. Fradley ; Ramach ; ran S. Vasan ; Patrick T. Ellinor ; Thomas J. Wang ; Emelia J. Benjamin
• 刊名：American Heart Journal
• 出版年：January, 2014
• 年：2014
• 卷：167
• 期：1
• 页码：109-115.e2
• 全文大小：643 K

文摘

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Background

We investigated whether circulating concentrations of soluble ST2, growth differentiation factor-15 (GDF-15), and high-sensitivity troponin I (hsTnI) are associated with incident atrial fibrillation (AF) and whether these biomarkers improve current risk prediction models including AF risk factors, B-type natriuretic peptide (BNP), and C-reactive protein (CRP).

Methods

We studied the relation between soluble ST2, GDF-15, and hsTnI and development of AF in Framingham Heart Study participants without prevalent AF. We used Cox proportional hazard regression analysis to examine the relation of incident AF during a 10-year follow-up period with each biomarker. We adjusted for standard AF clinical risk factors, BNP, and CRP.

Results

The mean age of the 3,217 participants was 59 卤 10 years, and 54% were women. During a 10-year follow-up, 242 participants developed AF. In age- and sex-adjusted models, GDF-15 and hsTnI were associated with risk of incident AF; however, after including the AF risk factors and BNP and CRP, only hsTnI was significantly associated with AF (hazard ratio per 1 SD of logb>eb> hsTnI, 1.12, 95% CI 1.00-1.26, P = .045). The c statistic of the base model including AF risk factors, BNP, and CRP was 0.803 (95% CI 0.777-0.830) and did not improve by adding individual or all 3 biomarkers. None of the discrimination and reclassification statistics were significant compared with the base model.

Conclusion

In a community-based cohort, circulating hsTnI concentrations were associated with incident AF. None of the novel biomarkers evaluated improved AF risk discrimination or reclassification beyond standard clinical AF risk factors and biomarkers.