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The ABC (age, bioma...
The ABC (age, biomarkers, clinical history) stroke risk score : a biomarker-based risk score for predicting stroke in atrial fibrillation
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- Hijazi, Ziad (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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- Lindbäck, Johan (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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- Alexander, John H. (author)
- Duke Med, Duke Clin Res Inst, Durham, NC USA.
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- Hanna, Michael (author)
- Bristol Myers Squibb Co, Princeton, NJ USA.
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- Held, Claes (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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- Hylek, Elaine M. (author)
- Boston Univ, Med Ctr, Boston, MA USA.
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- Lopes, Renato D. (author)
- Duke Med, Duke Clin Res Inst, Durham, NC USA.
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- Oldgren, Jonas (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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- Siegbahn, Agneta (author)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Uppsala kliniska forskningscentrum (UCR)
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- Stewart, Ralph A. H. (author)
- Auckland City Hosp, Green Lane Cardiovasc Serv, Auckland, New Zealand.;Univ Auckland, Auckland 1, New Zealand.
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- White, Harvey D. (author)
- Auckland City Hosp, Green Lane Cardiovasc Serv, Auckland, New Zealand.;Univ Auckland, Auckland 1, New Zealand.
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- Granger, Christopher B. (author)
- Duke Med, Duke Clin Res Inst, Durham, NC USA.
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- Wallentin, Lars (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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(creator_code:org_t)
- 2016-02-25
- 2016
- English.
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In: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 37:20, s. 1582-1590
- Related links:
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https://academic.oup...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Subject headings
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- Aims: Atrial fibrillation (AF) is associated with an increased risk of stroke, which is currently estimated by clinical characteristics. The cardiac biomarkers N-terminal fragment B-type natriuretic peptide (NT-proBNP) and cardiac troponin high-sensitivity (cTn-hs) are independently associated with risk of stroke in AF. Our objective was to develop and validate a new biomarker-based risk score to improve prognostication of stroke in patients with AF.Methods: and results A new risk score was developed and internally validated in 14 701 patients with AF and biomarkers levels determined at baseline, median follow-up of 1.9 years. Biomarkers and clinical variables significantly contributing to predicting stroke or systemic embolism were assessed by Cox-regression and each variable obtained a weight proportional to the model coefficients. External validation was performed in 1400 patients with AF, median follow-up of 3.4 years. The most important predictors were prior stroke/transient ischaemic attack, NT-proBNP, cTn-hs, and age, which were included in the ABC (Age, Biomarkers, Clinical history) stroke risk score. The ABC-stroke score was well calibrated and yielded higher c-indices than the widely used CHA2DS2-VASc score in both the derivation cohort (0.68 vs. 0.62, P < 0.001) and the external validation cohort (0.66 vs. 0.58, P < 0.001). Moreover, the ABC-stroke score consistently provided higher c-indices in several important subgroups.Conclusion: A novel biomarker-based risk score for predicting stroke in AF was successfully developed and internally validated in a large cohort of patients with AF and further externally validated in an independent AF cohort. The ABC-stroke score performed better than the presently used clinically based risk score and may provide improved decision support in AF.
Keyword
- Atrial fibrillation
- Biomarkers
- Natriuretic peptides
- Risk score
- Stroke
- Troponin
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Hijazi, Ziad
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Lindbäck, Johan
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Alexander, John ...
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Hanna, Michael
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Held, Claes
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Hylek, Elaine M.
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show more...
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Lopes, Renato D.
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Oldgren, Jonas
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Siegbahn, Agneta
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Stewart, Ralph A ...
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White, Harvey D.
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Granger, Christo ...
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Wallentin, Lars
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show less...
- Articles in the publication
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European Heart J ...
- By the university
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Uppsala University