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Evaluation of the p...
Evaluation of the prognostic value of GDF-15, ABC-AF-bleeding score and ABC-AF-death score in patients with atrial fibrillation across different geographical areas
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- Pol, Tymon (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi,Uppsala Univ, Dept Med Sci, Cardiol, Uppsala, Sweden.;Uppsala Univ, Uppsala Clin Res Ctr, Uppsala, Sweden.
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- Hijazi, Ziad (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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- Lindbäck, Johan (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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- Alexander, John H. (author)
- Duke Hlth, Duke Clin Res Inst, Durham, NC USA.
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- Bahit, M. Cecilia (author)
- Fdn INECO, INECO Neurociencias Orono, Rosario, Argentina.
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- De Caterina, Raffaele (author)
- Gabriele dAnnunzio Univ, Chieti, Italy.
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- Eikelboom, J. W. (author)
- Populat Hlth Res Inst, Hamilton, ON, Canada.
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- Ezekowitz, Michael D. (author)
- Thomas Jefferson Med Coll & Heart Ctr, Wynnewood, PA USA.
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- Gersh, Bernard J. (author)
- Mayo Clin, Coll Med, Rochester, MN USA.
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- Granger, Christopher B. (author)
- Duke Hlth, Duke Clin Res Inst, Durham, NC USA.
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- Hylek, Elaine M. (author)
- Boston Univ, Med Ctr, Boston, MA USA.
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- Lopes, Renato (author)
- Duke Hlth, Duke Clin Res Inst, Durham, NC USA.
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- Siegbahn, Agneta, 1947- (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Klinisk kemi
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- Wallentin, Lars, 1943- (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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(creator_code:org_t)
- 2021-03-19
- 2021
- English.
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In: Open heart. - : BMJ Publishing Group Ltd. - 2053-3624. ; 8:1
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https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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Abstract
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- Objectives Growth differentiation factor 15 (GDF-15) is a biomarker independently associated with bleeding and death in anticoagulated patients with atrial fibrillation (AF). GDF-15 is also used as one component in the more precise biomarker-based ABC (age, biomarkers, clinical history)-AF-bleeding and ABC-AF-death risk scores. Data from large trials indicate a geographic variability in regard to overall outcomes, including bleeding and mortality risk. Our aim was to assess the consistency of the association between GDF-15, ABC-AF-bleeding score and ABC-AF-death score, with major bleeding and death, across world geographic regions. Methods Data were available from 14 767 patients with AF from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial and 8651 patients with AF from the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) trial in this cohort study. GDF-15 was analysed from plasma samples obtained at randomisation. The geographical consistency of the associations between outcomes and GDF-15, ABC-AF-bleeding score and ABC-AF-death scores were assessed by Cox-regression models including interactions with predefined geographical region. Results GDF-15 and the ABC-AF-bleeding score were associated with major bleeding in both trials across regions (p<0.0001). Similarly, GDF-15 and the ABC-AFdeath score were associated with all-cause mortality in both trials across regions (p<0.0001). Overall, the association between GDF-15, the ABC-AF-bleeding score and ABC-AF-death risk score with major bleeding and death was consistent across regions in both ARISTOTLE and the RE-LY trial cohorts. The ABC-AF-bleeding and ABC-AF-death risk scores were consistent regarding discriminative ability when comparing geographic regions in both trial cohorts. The C-indices ranged from 0.649 to 0.760 for the ABC-AF-bleeding and from 0.677 to 0.806 for the ABC-AF-death score by different geographic regions. Conclusions In patients with AF on anticoagulation, GDF-15 and the biomarker-based ABC-AF-bleeding and ABC-AF-death risk scores are consistently associated with respectively increased risk of major bleeding and death and have similar prognostic value across world geographic regions.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
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Pol, Tymon
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Hijazi, Ziad
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Lindbäck, Johan
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Alexander, John ...
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Bahit, M. Cecili ...
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De Caterina, Raf ...
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Eikelboom, J. W.
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Ezekowitz, Micha ...
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Gersh, Bernard J ...
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Granger, Christo ...
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Hylek, Elaine M.
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Lopes, Renato
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Siegbahn, Agneta ...
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Wallentin, Lars, ...
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- MEDICAL AND HEALTH SCIENCES
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Open heart
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Uppsala University