Biomarkers for predicting atrial fibrillation: An explorative sub-analysis of the randomised SCREEN-AF trial
AbstractBackground 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 pract...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | European Journal of General Practice |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/13814788.2024.2327367 |
| _version_ | 1797258410028171264 |
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| author | Katharina Schmalstieg-Bahr David J. Gladstone Eva Hummers Johanna Suerbaum Jeff S. Healey Antonia Zapf Denise Köster Stefanie M. Werhahn Rolf Wachter |
| author_facet | Katharina Schmalstieg-Bahr David J. Gladstone Eva Hummers Johanna Suerbaum Jeff S. Healey Antonia Zapf Denise Köster Stefanie M. Werhahn Rolf Wachter |
| author_sort | Katharina Schmalstieg-Bahr |
| collection | DOAJ |
| description | AbstractBackground 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. |
| first_indexed | 2024-04-24T22:53:05Z |
| format | Article |
| id | doaj.art-e5adfa37140e4ce1a170424c4d4392ec |
| institution | Directory Open Access Journal |
| issn | 1381-4788 1751-1402 |
| language | English |
| last_indexed | 2024-04-24T22:53:05Z |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | European Journal of General Practice |
| spelling | doaj.art-e5adfa37140e4ce1a170424c4d4392ec2024-03-18T10:22:14ZengTaylor & Francis GroupEuropean Journal of General Practice1381-47881751-14022024-12-0130110.1080/13814788.2024.2327367Biomarkers for predicting atrial fibrillation: An explorative sub-analysis of the randomised SCREEN-AF trialKatharina Schmalstieg-Bahr0David J. Gladstone1Eva Hummers2Johanna Suerbaum3Jeff S. Healey4Antonia Zapf5Denise Köster6Stefanie M. Werhahn7Rolf Wachter8Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDivision of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, CanadaDepartment of General Practice, University Medical Center Göttingen, Göttingen, GermanyDZHK (German Centre for Cardiovascular Research), Partner Site Göttingen, Göttingen, GermanyPopulation Health Research Institute, McMaster University, Hamilton, Ontario, CanadaInstitute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyInstitute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Cardiology, University Medical Center Göttingen, Göttingen, GermanyDZHK (German Centre for Cardiovascular Research), Partner Site Göttingen, Göttingen, GermanyAbstractBackground 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.https://www.tandfonline.com/doi/10.1080/13814788.2024.2327367ClinicalTrials.gov Identifier: NCT02392754www.DZHK.de: SCREEN-AF DZHK15Atrial fibrillationnatriuretic peptidesscreeningprediction |
| spellingShingle | Katharina Schmalstieg-Bahr David J. Gladstone Eva Hummers Johanna Suerbaum Jeff S. Healey Antonia Zapf Denise Köster Stefanie M. Werhahn Rolf Wachter Biomarkers for predicting atrial fibrillation: An explorative sub-analysis of the randomised SCREEN-AF trial European Journal of General Practice ClinicalTrials.gov Identifier: NCT02392754 www.DZHK.de: SCREEN-AF DZHK15 Atrial fibrillation natriuretic peptides screening prediction |
| title | Biomarkers for predicting atrial fibrillation: An explorative sub-analysis of the randomised SCREEN-AF trial |
| title_full | Biomarkers for predicting atrial fibrillation: An explorative sub-analysis of the randomised SCREEN-AF trial |
| title_fullStr | Biomarkers for predicting atrial fibrillation: An explorative sub-analysis of the randomised SCREEN-AF trial |
| title_full_unstemmed | Biomarkers for predicting atrial fibrillation: An explorative sub-analysis of the randomised SCREEN-AF trial |
| title_short | Biomarkers for predicting atrial fibrillation: An explorative sub-analysis of the randomised SCREEN-AF trial |
| title_sort | biomarkers for predicting atrial fibrillation an explorative sub analysis of the randomised screen af trial |
| topic | ClinicalTrials.gov Identifier: NCT02392754 www.DZHK.de: SCREEN-AF DZHK15 Atrial fibrillation natriuretic peptides screening prediction |
| url | https://www.tandfonline.com/doi/10.1080/13814788.2024.2327367 |
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