Abstract 12613: High-sensitivity Troponin-I is Predictive of Incident Atrial Fibrillation in a High-Risk Patient Population
Introduction: Biomarkers have been linked to incident atrial fibrillation (AF) in the general population. We evaluated the association between several biomarkers previously shown to be predictors of death and myocardial infarction (MI), and development of AF in a high-risk patient population with CAD.
Hypothesis: Biomarkers will predict new-onset AF in a population with CAD.
Methods: 2773 patients (age 62±13 years) with known or suspected CAD were enrolled in the Emory Cardiovascular Biobank. Circulating levels of high-sensitivity troponin I (hs-TnI), fibrin degradation products (FDP), c-reactive protein (CRP), soluble urokinase-type plasminogen activator receptor (suPAR), and heat shock protein 70 (HSP70) were measured with ELISA. Biomakers were dichotomized into high or low levels by median, as well as into quartiles. Cox proportional hazard models were used to investigate the associations between biomarkers and incident AF after adjustment for age, sex, race, body mass index (BMI), smoking history, hypertension, diabetes, hyperlipidemia, history of MI, CAD severity by Gensini score, estimated glomerular filtration rate, and use of ACE inhibitors/ARBs/statins.
Results: During a median 5.75 years of follow-up, 423 (15.3%) patients developed AF. Subjects with incident AF were older, had higher BMI, greater CAD severity, lower eGFR, and more often had prior MI. Elevated levels of hs-TnI (≥median 4.7 pg/mL) were associated with incident AF (hazard ratio (HR) 2.00, [95% confidence interval (CI) 1.60-2.51], P<0.001), that remained significant after adjustment for the aforementioned covariates (HR 1.75, 95%CI 1.33-2.31, P<0.0001). The findings were supported by quartile analysis when comparing the first quartile to the fourth quartile (HR 1.82, 95% CI 1.23-2.70, p=0.003 after adjustment). FDP, suPAR, CRP, and HSP70 were not associated with incident AF after adjustment for covariates.
Conclusions: In subjects with CAD, higher hs-TnI levels are associated with incident AF even after adjustment for severity of CHD. Risk stratification for incident AF may permit institution of more aggressive risk factor modification and targeted screening.
Author Disclosures: W. Schultz: None. S. Hayek: None. Y. Ko: None. J. Lisko: None. M. Awad: None. K. Hosny: None. H. Ahmed: None. K. Patel: None. M. Yuan: None. J. Hartsfield: None. B. Gray: None. R. Bhimani: None. J. Kim: None. L. Shaw: None. P. Wilson: None. V. Vaccarino: None. A. Quyyumi: None.
- © 2016 by American Heart Association, Inc.