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Insulin-like growth factor-binding protein 7 and risk of congestive heart failure hospitalization in patients with atrial fibrillation

2020; Elsevier BV; Volume: 18; Issue: 4 Linguagem: Inglês

10.1016/j.hrthm.2020.11.028

1556-3871

Steffen Blum, Stefanie Aeschbacher, Pascal Meyre, Michael Kühne, Nicolas Rodondi, Jürg H. Beer, Peter Ammann, Giorgio Moschovitis, Leo H. Bonati, Manuel R. Blum, Peter Kastner, Fiona Baguley, Christian Sticherling, Stefan Osswald, David Conen, Stefanie Aeschbacher, Chloé Auberson, Steffen Blum, Leo H. Bonati, Selinda Ceylan, David Conen, Simone Doerpfeld, Ceylan Eken, Marc Girod, Peter Hämmerle, Philipp Krisai, Michael Kühne, Christine Meyer‐Zürn, Pascal Meyre, Andreas U. Monsch, Christian Müller, Stefan Osswald, Anne Springer, Christian Sticherling, Thomas D. Szucs, Gian Voellmin, Leon Zwimpfer, Stefan Osswald, Michael Kühne, Drahomir Aujesky, Urs Fischer, Juerg Fuhrer, Laurent Roten, Simon Jung, Heinrich P. Mattle, Luise Adam, Carole E. Aubert, Martin Feller, Axel Loewe, Elisavet Moutzouri, Claudio Schneider, Tanja Flückiger, Cindy Groen, Lukas Ehrsam, Sven Hellrigl, Alexandra Nuoffer, Damiana Rakovic, Nathalie Schwab, Rylana Wenger, Nicolas Rodondi, Christopher Beynon, Roger Dillier, Michèle Deubelbeiss, Franz R. Eberli, C Franzini, Isabel Juchli, Claudia Liedtke, Jacqueline Nadler, Thayze Obst, Jasmin Roth, Fiona Schlomowitsch, Xiaoye Schneider, Katrin Studerus, Noreen Tynan, Dominik Weishaupt, Andreas Müller, Simone Fontana, Silke Küest, Karin Scheuch, Denise Hischier, Nicole R. Bonetti, Alexandra Grau, Jonas Villinger, Eva Laube, Philipp Baumgartner, Mark G. Filipovic, Marcel Frick, Giulia Montrasio, S. Leuenberger, Franziska Rutz, Jürg H. Beer, Angelo Auricchio, Adriana Anesini, Cristina Camporini, Giulio Conte, Maria Luce Caputo, François Regoli, Tiziano Moccetti, Roman Brenner, David Altmann, Michaela Gemperle, Peter Ammann, Mathieu Firmann, Sandrine Foucras, Martine Rime, Daniel Hayoz, Benjamin Berte, Virgina Justi, Frauke Kellner‐Weldon, Brigitta Mehmann, Sonja Meier, Myriam Roth, Andrea Ruckli-Kaeppeli, Ian Russi, Kai Schmidt, Mabelle Young, Melanie Zbinden, Richard Kobza, Jane Frangi-Kultalahti, Anica Pin, Luisa Vicari, Giorgio Moschovitis, Georg Ehret, Hervé Gallet, Elise Guillermet, François Lazeyras, Karl‐Olof Lövblad, Patrick Perret, Philippe Tavel, Cheryl Terés, Dipen Shah, Nathalie Lauriers, Marie Méan, Sandrine Salzmann, Jürg Schläpfer, Andrea Grêt, Ján Novák, Sandra Vitelli, Frank‐Peter Stephan, Jane Frangi-Kultalahti, Augusto Gallino, Marcello Di Valentino, Fabienne Witassek, Matthias Schwenkglenks, Jens Würfel, Anna Altermatt, Michael Amann, P Huber, Esther Ruberte, Tim Sinnecker, Vanessa Zuber, Michael Coslovsky, Pascal Benkert, Gilles Dutilh, Milica Marković, Patrick Simon, Ramun Schmid,

Heart Failure Treatment and Management

Background The occurrence of congestive heart failure (CHF) hospitalization among patients with atrial fibrillation (AF) is a poor prognostic marker. Objective The purpose of this study was to assess whether insulin-like growth factor-binding protein 7 (IGFBP-7), a marker of myocardial damage, identifies AF patients at high risk for this complication. Methods We analyzed 2 prospective multicenter observational cohort studies that included 3691 AF patients. Levels of IGFBP-7 and N-terminal pro–brain natriuretic peptide (NT-proBNP) were measured from frozen plasma samples at baseline. The primary endpoint was hospitalization for CHF. Multivariable adjusted Cox regression analyses were constructed. Results Mean patient age was 69 ± 12 years, 1028 (28%) were female, and 879 (24%) had a history of CHF. The incidence per 1000 patient-years across increasing IGFBP-7 quartiles was 7, 10, 32, and 85. The corresponding multivariable adjusted hazard ratios (aHRs) (95% confidence interval [CI]) were 1.0, 1.05 (0.63–1.77), 2.38 (1.50–3.79), and 4.37 (2.72–7.04) (P for trend <.001). In a subgroup of 2812 patients without pre-existing CHF at baseline, the corresponding aHRs were 1.0, 0.90 (0.47–1.72), 1.69 (0.94–3.04), and 3.48 (1.94–6.24) (P for trend <.001). Patients with IGFBP-7 and NT-proBNP levels above the biomarker-specific median had a higher risk of incident CHF hospitalization (aHR 5.20; 3.35–8.09) compared to those with only 1 elevated marker (elevated IGFBP-7 aHR 2.17; 1.30–3.60); elevated NT-proBNP aHR 1.97; 1.17–3.33); or no elevated marker (reference). Conclusion Higher plasma levels of IGFBP-7 were strongly and independently associated with CHF hospitalization in AF patients. The prognostic information provided by IGFBP-7 was additive to that of NT-proBNP. The occurrence of congestive heart failure (CHF) hospitalization among patients with atrial fibrillation (AF) is a poor prognostic marker. The purpose of this study was to assess whether insulin-like growth factor-binding protein 7 (IGFBP-7), a marker of myocardial damage, identifies AF patients at high risk for this complication. We analyzed 2 prospective multicenter observational cohort studies that included 3691 AF patients. Levels of IGFBP-7 and N-terminal pro–brain natriuretic peptide (NT-proBNP) were measured from frozen plasma samples at baseline. The primary endpoint was hospitalization for CHF. Multivariable adjusted Cox regression analyses were constructed. Mean patient age was 69 ± 12 years, 1028 (28%) were female, and 879 (24%) had a history of CHF. The incidence per 1000 patient-years across increasing IGFBP-7 quartiles was 7, 10, 32, and 85. The corresponding multivariable adjusted hazard ratios (aHRs) (95% confidence interval [CI]) were 1.0, 1.05 (0.63–1.77), 2.38 (1.50–3.79), and 4.37 (2.72–7.04) (P for trend <.001). In a subgroup of 2812 patients without pre-existing CHF at baseline, the corresponding aHRs were 1.0, 0.90 (0.47–1.72), 1.69 (0.94–3.04), and 3.48 (1.94–6.24) (P for trend <.001). Patients with IGFBP-7 and NT-proBNP levels above the biomarker-specific median had a higher risk of incident CHF hospitalization (aHR 5.20; 3.35–8.09) compared to those with only 1 elevated marker (elevated IGFBP-7 aHR 2.17; 1.30–3.60); elevated NT-proBNP aHR 1.97; 1.17–3.33); or no elevated marker (reference). Higher plasma levels of IGFBP-7 were strongly and independently associated with CHF hospitalization in AF patients. The prognostic information provided by IGFBP-7 was additive to that of NT-proBNP.