亲爱的研友该休息了!由于当前在线用户较少,发布求助请尽量完整的填写文献信息,科研通机器人24小时在线,伴您度过漫漫科研夜!身体可是革命的本钱,早点休息,好梦!

Heart Failure Risk Assessment Using Biomarkers in Patients With Atrial Fibrillation

医学 心房颤动 心力衰竭 心脏病学 内科学 危险系数 阿哌沙班 心肌梗塞 利钠肽 比例危险模型 冲程(发动机) 华法林 拜瑞妥 置信区间 机械工程 工程类
作者
Paul M. Haller,Petr Jarolı́m,Michael G. Palazzolo,Andrea Bellavia,Elliott M. Antman,John W. Eikelboom,Christopher B. Granger,Josephine Harrington,Jeff S. Healey,Ziad Hijazi,Manesh R. Patel,Siddharth Patel,Christian T. Ruff,Lars Wallentin,Eugene Braunwald,Robert P. Giugliano,David A. Morrow
出处
期刊:Journal of the American College of Cardiology [Elsevier]
被引量:1
标识
DOI:10.1016/j.jacc.2024.07.023
摘要

Heart failure (HF) is common among patients with atrial fibrillation (AF), and accurate risk assessment is clinically important. The goal of this study was to investigate the incremental prognostic performance of N-terminal pro–B-type natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin T (hs-cTnT), and growth differentiation factor (GDF)-15 for HF risk stratification in patients with AF. Individual patient data from 3 large randomized trials comparing direct oral anticoagulants (DOACs) with warfarin (ARISTOTLE [Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation], ENGAGE AF-TIMI 48 [Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation–Thrombolysis in Myocardial Infarction 48], and RE-LY [Randomized Evaluation of Long-Term Anticoagulation Therapy]) from the COMBINE-AF (A Collaboration Between Multiple Institutions to Better Investigate Non-Vitamin K Antagonist Oral Anticoagulant Use in Atrial Fibrillation) cohort were pooled; all patients with available biomarkers at baseline were included. The composite endpoint was hospitalization for HF (HHF) or cardiovascular death (CVD), and secondary endpoints were HHF and HF-related death. Cox regression was used, adjusting for clinical factors, and interbiomarker correlation was addressed using weighted quantile sum regression analysis. In 32,041 patients, higher biomarker values were associated with a graded increase in absolute risk for CVD/HHF, HHF, and HF-related death. Adjusting for clinical variables and all biomarkers, NT-proBNP (HR per 1 SD: 1.68; 95% CI: 1.59-1.77), hs-cTnT (HR: 1.39; 95% CI: 1.33-1.44), and GDF-15 (HR: 1.20; 95% CI: 1.15-1.25) were significantly associated with CVD/HHF. The discrimination of the clinical model improved significantly upon addition of the biomarkers (c-index: 0.70 [95% CI: 0.69-0.71] to 0.77 [95% CI: 0.76-0.78]; likelihood ratio test, P < 0.001). Using weighted quantile sum regression analysis, the contribution to risk assessment was similar for NT-proBNP and hs-cTnT for CVD/HHF (38% and 41%, respectively); GDF-15 provided a statistically significant but lesser contribution to risk assessment. Results were similar for HHF and HF-related death, individually, and across key subgroups of patients based on history of HF, AF pattern, and reduced or preserved left ventricular ejection fraction. NT-proBNP, hs-cTnT, and GDF-15 contributed significantly and independently to the risk stratification for HF endpoints in patients with AF, with hs-cTnT being as important as NT-proBNP for HF risk stratification. Our findings support a possible future use of these biomarkers to distinguish patients with AF at low or high risk for HF.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
32秒前
35秒前
1分钟前
SciGPT应助忧心的寄松采纳,获得10
1分钟前
标致诗双发布了新的文献求助10
1分钟前
1分钟前
1分钟前
ljjyy发布了新的文献求助10
1分钟前
lovelife完成签到,获得积分10
1分钟前
1分钟前
1分钟前
zai完成签到 ,获得积分10
1分钟前
1分钟前
kyfbrahha完成签到 ,获得积分10
1分钟前
1分钟前
2分钟前
2分钟前
胡娇发布了新的文献求助10
2分钟前
taoxz521完成签到 ,获得积分10
2分钟前
标致诗双完成签到,获得积分10
2分钟前
Noctis发布了新的文献求助10
2分钟前
3分钟前
情怀应助科研通管家采纳,获得10
3分钟前
3分钟前
踏实的研完成签到,获得积分10
3分钟前
研友_闾丘枫完成签到 ,获得积分10
3分钟前
3分钟前
3分钟前
3分钟前
实力不允许完成签到 ,获得积分10
4分钟前
TXZ06完成签到,获得积分10
4分钟前
xqq完成签到,获得积分10
4分钟前
4分钟前
4分钟前
一路微笑完成签到,获得积分10
5分钟前
6分钟前
JamesPei应助liuyannong采纳,获得10
6分钟前
6分钟前
D4发布了新的文献求助10
6分钟前
6分钟前
高分求助中
The ACS Guide to Scholarly Communication 2500
Sustainability in Tides Chemistry 2000
Studien zur Ideengeschichte der Gesetzgebung 1000
TM 5-855-1(Fundamentals of protective design for conventional weapons) 1000
Threaded Harmony: A Sustainable Approach to Fashion 810
Pharmacogenomics: Applications to Patient Care, Third Edition 800
Free Will in the Flesh 500
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3081568
求助须知:如何正确求助?哪些是违规求助? 2734399
关于积分的说明 7532720
捐赠科研通 2383882
什么是DOI,文献DOI怎么找? 1264075
科研通“疑难数据库(出版商)”最低求助积分说明 612561
版权声明 597578