Biomarkers for Heart Failure Hospitalization Recognized in AF Patients

Baseline C-reactive protein, cystatin C, development differentiation factor 15, interleukin-6 (IL-6), N-terminal B-sort natriuretic peptide (NT-proBNP), and troponin T ranges are helpful biomarkers for heart failure (HF) Hospitalization and mortality in individuals with atrial fibrillation (AF). These findings are american coronary heart journal.

The apixaban (ARISTOTLE ClinicalTrials.gov Identifier: NCT00412984) demo for reduction of stroke and other thromboembolic events in atrial fibrillation was a double-blind, double-dummy, multicenter demo. In this substudy of ARISTOTLE data, atrial fibrillation with minimized ejection portion (HFrEF n=2048), heart failure with preserved ejection fraction (HFpEF n=2520), and coronary heart failure with no heart failure (HFrEF n=2048) n=7250).

The HFrEF, HFpEF, and no HF cohorts consisted of 20.6%, 42.7%, and 35.7% ladies. Median ages were 67., 69., and 70. many years. 50.4%, 49.4%, and 50.1% were being randomly assigned to warfarin. 89.6%, 85.%, and 81.5% experienced permanent or persistent AF, respectively.


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The distribution of biomarkers was identical for all markers besides C-reactive protein, with HFrEF related with the greatest values ​​and no HF linked with the cheapest values ​​for the other markers.Distributions of all markers were being appreciably distinct in between groups (all P. <.001).

During a median follow-up of 1.9 years, 546 patients were hospitalized with HF and 819 died. The event rate was higher in the HFrEF cohort and lowest in the HFrEF cohort. Consistent associations were observed across biomarkers, with higher levels being associated with higher likelihood of heart failure hospitalization and all-cause mortality.

After fully adjusting for covariates, NT-proBNP (c2101.6 P. <.0001), Troponin T (c236.1 P. <.0001), IL-6 (c223.2 P. =.0001), growth differentiation factor-15 (c220.2 P. =.0005) levels were significantly associated with first hospitalization for heart failure.

After adjusting for all covariates, there was evidence of an interaction between HF status and Troponin T at first hospitalization for HF (c26.19 P. =.0454) and a non-linear relationship was observed between HF status and NT-proBNP (c24.69 P. =.0303) and IL-6 (c24.71 P. =.0301) after adjustment.

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Because this patient population was recruited for a clinical trial and all patients had at least one risk factor for stroke, the results of this study may not be generalizable.

“In patients receiving anticoagulant therapy for atrial fibrillation, biomarkers of cardiorenal dysfunction and inflammation may improve identification of patients with atrial fibrillation at risk of developing heart failure or exacerbating existing heart failure. do,” the study authors wrote. “These biomarkers may help target additional her HF treatments in patients with atrial fibrillation.”

Disclosure: Several authors have declared industry affiliations. See the original article for the full list of disclosures.

reference

Aulin J, Hijazi Z, Lindbäck J and others on behalf of the ARISTOTLE Investigators. Biomarkers and heart failure events in patients with atrial fibrillation in his ARISTOTLE trial assessed by a multistate model. Amhart JPublished online May 13, 2022. doi:10.1016/j.ahj.2022.03.009

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