Abstract 10263: Biomarkers of Distinct Pathophysiological Pathways in Atrial Fibrillation in the General Population
Background Known risk factors for atrial fibrillation (AF) explain only 60-70% of the population-attributable risk. Whether easily measurable blood biomarkers from a broad range of pathophysiological pathways are related to AF in the general population is little understood.
Methods and Results In a population-based sample (mean age 55±11 years, age range 35-75 years; 49.2% women) we assessed biomarkers of cardiovascular function (mid-regional pro adrenomedullin [MR-proADM], mid-regional pro atrial natriuretic peptide [MR-proANP], N-terminal pro B-type natriuretic peptide [Nt-proBNP], copeptin, C-terminal pro endothelin-1, troponin I); inflammation (C-reactive protein [CRP], fibrinogen, neopterin); and oxidative stress (asymmetric dimethylarginine, glutathione-peroxidase-1, myeloperoxidase) in relation to manifest AF (n=161 cases) in a total of 5000 individuals. Most biomarkers except for glutathione-peroxidase-1 and myeloperoxidase were elevated in AF individuals, P<0.0001. In Bonferroni-corrected (14 tests) multivariable-adjusted logistic regression analyses, MR-proADM odds ratio [OR] per standard deviation increase 1.61 (99.64% confidence interval [CI] 1.24-2.09), MR-proANP OR 2.48 (99.64% CI 1.92-3.20), C-terminal pro endothelin-1 OR 1.47 (99.64% CI 1.16-1.87), Nt-proBNP OR 2.96 (99.64% CI 2.18-4.02), troponin I OR 1.44 (99.64% CI 1.17-1.77), and fibrinogen OR 1.47 (99.6% CI 1.20-1.79), remained statistically significantly associated with prevalent AF, all P<0.0001. Results were comparable in patients with AF vs. sinus rhythm at blood draw.
Conclusions We report on MR-proADM and C-terminal pro endothelin-1 as strong correlates of AF in the general population. The inflammatory biomarker fibrinogen and neurohumoral markers, Nt-proBNP and MR-proANP, were confirmed. Whether biomarker measurement improves risk prediction in AF needs to be investigated.
- © 2011 by American Heart Association, Inc.