Relation between soluble ST2, growth differentiation factor-15, and high-sensitivity troponin I and incident atrial fibrillation Journal Article

Authors: Rienstra, M.; Yin, X.; Larson, M. G.; Fontes, J. D.; Magnani, J. W.; McManus, D. D.; McCabe, E. L.; Coglianese, E. E.; Amponsah, M.; Ho, J. E.; Januzzi, J. L., Jr; Wollert, K. C.; Fradley, M. G.; Vasan, R. S.; Ellinor, P. T.; Wang, T. J.; Benjamin, E. J.
Article Title: Relation between soluble ST2, growth differentiation factor-15, and high-sensitivity troponin I and incident atrial fibrillation
Abstract: BACKGROUND: We investigated whether circulating concentrations of soluble ST2, growth differentiation factor-15 (GDF-15), and high-sensitivity troponin I (hsTnI) are associated with incident atrial fibrillation (AF) and whether these biomarkers improve current risk prediction models including AF risk factors, B-type natriuretic peptide (BNP), and C-reactive protein (CRP). METHODS: We studied the relation between soluble ST2, GDF-15, and hsTnI and development of AF in Framingham Heart Study participants without prevalent AF. We used Cox proportional hazard regression analysis to examine the relation of incident AF during a 10-year follow-up period with each biomarker. We adjusted for standard AF clinical risk factors, BNP, and CRP. RESULTS: The mean age of the 3,217 participants was 59 +/- 10 years, and 54% were women. During a 10-year follow-up, 242 participants developed AF. In age- and sex-adjusted models, GDF-15 and hsTnI were associated with risk of incident AF; however, after including the AF risk factors and BNP and CRP, only hsTnI was significantly associated with AF (hazard ratio per 1 SD of loge hsTnI, 1.12, 95% CI 1.00-1.26, P = .045). The c statistic of the base model including AF risk factors, BNP, and CRP was 0.803 (95% CI 0.777-0.830) and did not improve by adding individual or all 3 biomarkers. None of the discrimination and reclassification statistics were significant compared with the base model. CONCLUSION: In a community-based cohort, circulating hsTnI concentrations were associated with incident AF. None of the novel biomarkers evaluated improved AF risk discrimination or reclassification beyond standard clinical AF risk factors and biomarkers.
Journal Title: American Heart Journal
Volume: 167
Issue: 1
ISSN: 1097-6744; 0002-8703
Publisher: Mosby, Inc  
Journal Place: United States
Date Published: 2014
Start Page: 109
End Page: 115.e2
Language: eng
Notes: CI: (c) 2014; GR: K23 HL116780/HL/NHLBI NIH HHS/United States; GR: K24 HL105780/HL/NHLBI NIH HHS/United States; GR: R01 HL092577/HL/NHLBI NIH HHS/United States; GR: R01 HL104156/HL/NHLBI NIH HHS/United States; GR: RC1 HL101056/HL/NHLBI NIH HHS/United States; JID: 0370465; 2013/07/09 [received]; 2013/10/02 [accepted]; 2013/10/17 [aheadofprint]; ppublish