Cardiac Biomarkers and Left Ventricular Hypertrophy in Relation to Outcomes in Patients With Atrial Fibrillation: Experiences From the RE-LY Trial

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Hijazi, ZiadUppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi,Bertil Lindahl (author)

Cardiac Biomarkers and Left Ventricular Hypertrophy in Relation to Outcomes in Patients With Atrial Fibrillation : Experiences From the RE-LY Trial

Article/chapterEnglish2019

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2019
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LIBRIS-ID:oai:DiVA.org:uu-379402
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-379402URI
https://doi.org/10.1161/JAHA.118.010107DOI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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BackgroundCardiac biomarkers and left ventricular hypertrophy (LVH) are related to the risk of stroke and death in patients with atrial fibrillation. We investigated the interrelationship between LVH and cardiac biomarkers and their independent associations with outcomes.Methods and ResultsPlasma samples were obtained at baseline in 5275 patients with atrial fibrillation in the RE‐LY (Randomized Evaluation of Long‐Term Anticoagulation Therapy) trial. NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide), cardiac troponin I and T, and growth differentiation factor‐15 were determined using high‐sensitivity (hs) assays. LVH was defined by ECG. Cox models were adjusted for baseline characteristics, LVH, and biomarkers. LVH was present in 1257 patients. During a median follow‐up of 2.0 years, 165 patients developed a stroke and 370 died. LVH was significantly (P<0.0001) associated with higher levels of all biomarkers in linear regression analyses adjusting for baseline characteristics. Geometric mean ratios (95% CIs) were as follows: NT‐proBNP, 1.32 (1.25–1.38); hs cardiac troponin I, 1.67 (1.57–1.78); hs troponin T, 1.38 (1.32–1.44); and growth differentiation factor‐15, 1.09 (1.05–1.12). For stroke, the hazard ratios (95% CIs) per 50% increase were as follows: NT‐proBNP, 1.09 (1.00–1.19); hs cardiac troponin I, 1.09 (1.03–1.15); hs troponin T, 1.14 (1.06–1.24); and growth differentiation factor‐15, 1.22 (1.08–1.38) (all P<0.05). For death, hazard ratios (95% CIs) were as follows: NT‐proBNP, 1.24 (1.17–1.31); hs cardiac troponin I, 1.13 (1.10–1.17); hs troponin T, 1.28 (1.23–1.34); and growth differentiation factor‐15, 1.31 (1.22–1.42) (all P<0.0001). LVH was not significantly associated with stroke or death after adjustment for biomarkers.ConclusionsCardiac biomarkers are significantly associated with LVH. The prognostic value of biomarkers for stroke and death is not affected by LVH. The prognostic information of LVH is attenuated in the presence of cardiac biomarkers.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
atrial fibrillation
biomarker
left ventricular hypertrophy
risk prediction

Added entries (persons, corporate bodies, meetings, titles ...)

Verdecchia, PaoloHosp Assisi, Dept Med, Assisi, Italy (author)
Oldgren, Jonas,1964-Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR),Uppsala Univ, Dept Med Sci, Cardiol, Uppsala, Sweden;Uppsala Univ, Uppsala Clin Res Ctr, Uppsala, Sweden(Swepub:uu)jonaoldg (author)
Andersson, UlrikaUppsala universitet,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)ulran224 (author)
Reboldi, GianpaoloUniv Perugia, Dept Med, Perugia, Italy (author)
Di Pasquale, GiuseppeMaggiore Hosp, Dept Cardiol, Bologna, Italy (author)
Mazzotta, GiovanniHosp Assisi, Dept Med, Assisi, Italy (author)
Angeli, FabioUniv Perugia, Dept Cardiol & Cardiovasc Pathophysiol, Perugia, Italy (author)
Eikelboom, John W. (author)
Ezekowitz, Michael D.Thomas Jefferson Med Coll & Heart Ctr, Wynnewood, PA USA (author)
Connolly, Stuart J.Populat Hlth Res Inst, Hamilton, ON, Canada (author)
Yusuf, SalimPopulat Hlth Res Inst, Hamilton, ON, Canada (author)
Wallentin, Lars,1943-Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)larswall (author)
Uppsala universitetUppsala kliniska forskningscentrum (UCR) (creator_code:org_t)

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In:Journal of the American Heart Association8:22047-9980

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