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The ABC (age, bioma...
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Hijazi, ZiadUppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
(author)
The ABC (age, biomarkers, clinical history) stroke risk score : a biomarker-based risk score for predicting stroke in atrial fibrillation
- Article/chapterEnglish2016
Publisher, publication year, extent ...
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2016-02-25
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Oxford University Press (OUP),2016
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printrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:uu-298084
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-298084URI
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https://doi.org/10.1093/eurheartj/ehw054DOI
Supplementary language notes
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Language:English
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Summary in:English
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Classification
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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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.
Subject headings and genre
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Atrial fibrillation
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Biomarkers
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Natriuretic peptides
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Risk score
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Stroke
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Troponin
Added entries (persons, corporate bodies, meetings, titles ...)
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Lindbäck, JohanUppsala universitet,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)jolin255
(author)
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Alexander, John H.Duke Med, Duke Clin Res Inst, Durham, NC USA.
(author)
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Hanna, MichaelBristol Myers Squibb Co, Princeton, NJ USA.
(author)
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Held, ClaesUppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)clahe947
(author)
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Hylek, Elaine M.Boston Univ, Med Ctr, Boston, MA USA.
(author)
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Lopes, Renato D.Duke Med, Duke Clin Res Inst, Durham, NC USA.
(author)
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Oldgren, JonasUppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)jonaoldg
(author)
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Siegbahn, AgnetaUppsala universitet,Institutionen för medicinska vetenskaper,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)agsie424
(author)
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Stewart, Ralph A. H.Auckland City Hosp, Green Lane Cardiovasc Serv, Auckland, New Zealand.;Univ Auckland, Auckland 1, New Zealand.
(author)
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White, Harvey D.Auckland City Hosp, Green Lane Cardiovasc Serv, Auckland, New Zealand.;Univ Auckland, Auckland 1, New Zealand.
(author)
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Granger, Christopher B.Duke Med, Duke Clin Res Inst, Durham, NC USA.
(author)
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Wallentin, LarsUppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)larswall
(author)
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Uppsala universitetKardiologi
(creator_code:org_t)
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In:European Heart Journal: Oxford University Press (OUP)37:20, s. 1582-15900195-668X1522-9645
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Hijazi, Ziad
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Hanna, Michael
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Held, Claes
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Lopes, Renato D.
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Oldgren, Jonas
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Siegbahn, Agneta
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