Biomarkers for predicting atrial fibrillation: An explorative sub-analysis of the randomised SCREEN-AF trial
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Biomarkers for predicting atrial fibrillation: An explorative sub-analysis of the randomised SCREEN-AF trial. / Schmalstieg-Bahr, Katharina; Gladstone, David J; Hummers, Eva; Suerbaum, Johanna; Healey, Jeff S; Zapf, Antonia; Köster, Denise; Werhahn, Stefanie M; Wachter, Rolf.
In: EUR J GEN PRACT, Vol. 30, No. 1, 2327367, 18.03.2024.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Biomarkers for predicting atrial fibrillation: An explorative sub-analysis of the randomised SCREEN-AF trial
AU - Schmalstieg-Bahr, Katharina
AU - Gladstone, David J
AU - Hummers, Eva
AU - Suerbaum, Johanna
AU - Healey, Jeff S
AU - Zapf, Antonia
AU - Köster, Denise
AU - Werhahn, Stefanie M
AU - Wachter, Rolf
PY - 2024/3/18
Y1 - 2024/3/18
N2 - BACKGROUND: Atrial fibrillation (AF) is a common treatable risk factor for stroke. Screening for paroxysmal AF in general practice is difficult, but biomarkers might help improve screening strategies.OBJECTIVES: We investigated six blood biomarkers for predicting paroxysmal AF in general practice.METHODS: This was a pre-specified sub-study of the SCREEN-AF RCT done in Germany. Between 12/2017-03/2019, we enrolled ambulatory individuals aged 75 years or older with a history of hypertension but without known AF. Participants in the intervention group received active AF screening with a wearable patch, continuous ECG monitoring for 2x2 weeks and usual care in the control group. The primary endpoint was ECG-confirmed AF within six months after randomisation. High-sensitive Troponin I (hsTnI), brain natriuretic peptide (BNP), N-terminal pro-B-type natriuretic peptide (NT-pro BNP), N-terminal pro atrial natriuretic peptide (NT-ANP), mid-regional pro atrial natriuretic peptide (MR-pro ANP) and C-reactive protein (CRP) plasma levels were investigated at randomisation for predicting AF within six months after randomisation.RESULTS: Blood samples were available for 291 of 301 (96.7%) participants, including 8 with AF (3%). Five biomarkers showed higher median results in AF-patients: BNP 78 vs. 41 ng/L (p = 0.012), NT-pro BNP 273 vs. 186 ng/L (p = 0.029), NT-proANP 4.4 vs. 3.5 nmol/L (p = 0.027), MR-pro ANP 164 vs. 125 pmol/L (p = 0.016) and hsTnI 7.4 vs. 3.9 ng/L (p = 0.012). CRP levels were not different between groups (2.8 vs 1.9 mg/L, p = 0.1706).CONCLUSION: Natriuretic peptide levels and hsTnI are higher in patients with AF than without and may help select patients for AF screening, but larger trials are needed.
AB - BACKGROUND: Atrial fibrillation (AF) is a common treatable risk factor for stroke. Screening for paroxysmal AF in general practice is difficult, but biomarkers might help improve screening strategies.OBJECTIVES: We investigated six blood biomarkers for predicting paroxysmal AF in general practice.METHODS: This was a pre-specified sub-study of the SCREEN-AF RCT done in Germany. Between 12/2017-03/2019, we enrolled ambulatory individuals aged 75 years or older with a history of hypertension but without known AF. Participants in the intervention group received active AF screening with a wearable patch, continuous ECG monitoring for 2x2 weeks and usual care in the control group. The primary endpoint was ECG-confirmed AF within six months after randomisation. High-sensitive Troponin I (hsTnI), brain natriuretic peptide (BNP), N-terminal pro-B-type natriuretic peptide (NT-pro BNP), N-terminal pro atrial natriuretic peptide (NT-ANP), mid-regional pro atrial natriuretic peptide (MR-pro ANP) and C-reactive protein (CRP) plasma levels were investigated at randomisation for predicting AF within six months after randomisation.RESULTS: Blood samples were available for 291 of 301 (96.7%) participants, including 8 with AF (3%). Five biomarkers showed higher median results in AF-patients: BNP 78 vs. 41 ng/L (p = 0.012), NT-pro BNP 273 vs. 186 ng/L (p = 0.029), NT-proANP 4.4 vs. 3.5 nmol/L (p = 0.027), MR-pro ANP 164 vs. 125 pmol/L (p = 0.016) and hsTnI 7.4 vs. 3.9 ng/L (p = 0.012). CRP levels were not different between groups (2.8 vs 1.9 mg/L, p = 0.1706).CONCLUSION: Natriuretic peptide levels and hsTnI are higher in patients with AF than without and may help select patients for AF screening, but larger trials are needed.
KW - Humans
KW - Atrial Fibrillation/diagnosis
KW - Atrial Natriuretic Factor
KW - Biomarkers
KW - Stroke
KW - Germany
U2 - 10.1080/13814788.2024.2327367
DO - 10.1080/13814788.2024.2327367
M3 - SCORING: Journal article
C2 - 38497412
VL - 30
JO - EUR J GEN PRACT
JF - EUR J GEN PRACT
SN - 1381-4788
IS - 1
M1 - 2327367
ER -
