Heart failure & cardiomyopathies
Serial Assessment of Biomarkers and Heart Failure Outcomes in Patients with Atrial Fibrillation
Authors' conclusion
Serial measurement of hsTnT, NT-proBNP, and GDF-15 revealed that higher baseline values, and increasing or persistently elevated values over 1 year are associated with higher risk of HF outcomes in patients with AF regardless of HF history or HF phenotype based on EF.
Study context
- Population
- Patients with atrial fibrillation (AF) in the ENGAGE AF-TIMI 48 trial of edoxaban vs warfarin, with biomarkers measured at baseline and 12 months8,765 NT-proBNP
- Participants
- 926 / 1,043 / 2,027
- Comparison
- Higher vs lower baseline and 12-month change in high-sensitivity troponin T (hsTnT), NT-proBNP and GDF-15
- HFrEFn = 926
- HFmrEFn = 1,043
- HFpEFn = 2,027
- Primary endpoint
- Hospitalization for HF (HHF) or HF death
Methodological detailsnested biomarker study, 5207 with history of heart failure (HF); 3996 with known ejection fraction (EF)
- Nested biomarker study
- 5207 with history of HF; 3996 with known EF
Primary result
As reported in the abstract
HHF or HF death by elevated baseline hsTnT, NT-proBNP, GDF-15 · baseline
Elevated baseline hsTnT, NT-proBNP and GDF-15 associated with higher risk of hospitalization for HF (HHF) or HF death overall and in subpopulations by HF history and EF
p < 0.001 for each
Associations consistent regardless of HF history or EF
p-interaction >0.05 for each
Further findings
HHF or HF death by change in biomarkers over 12 months
- Increase in or persistently elevated values of any of the three biomarkers associated with higher risk of HHF or HF death in the overall population
- P < 0.001 for each biomarker and category
Original publication
Serial Assessment of Biomarkers and Heart Failure Outcomes in Patients with Atrial Fibrillation. Eur J Heart Fail. Published 18 April 2023. doi:10.
Summarised from the published abstract; every number is checked against it