Bone Morphogenetic Protein 10-A Novel Biomarker to Predict Adverse Outcomes in Patients With Atrial Fibrillation.

Publication

Bone Morphogenetic Protein 10-A Novel Biomarker to Predict Adverse Outcomes in Patients With Atrial Fibrillation.

Journal Paper/Review - Mar 16, 2023

Hennings Elisa, Blum Steffen, Aeschbacher Stefanie, Coslovsky Michael, Knecht Sven, Eken Ceylan, Lischer Mirko, Paladini Rebecca E, Krisai Philipp, Reichlin Tobias, Rodondi Nicolas, Beer Jürg Hans, Ammann Peter, Conte Giulio, De Perna Maria Luisa, Kobza Richard, Blum Manuel R, Bossard Matthias, Kästner Peter, Ziegler Andreas, Müller Arndt-Christian, Bonati Leo H, Pfister Otmar, Zuern Christine S, Conen David, Kühne Michael, Osswald Stefan, Swiss‐AF Investigators

Citation

Hennings E, Blum S, Aeschbacher S, Coslovsky M, Knecht S, Eken C, Lischer M, Paladini R, Krisai P, Reichlin T, Rodondi N, Beer J, Ammann P, Conte G, De Perna M, Kobza R, Blum M, Bossard M, Kästner P, Ziegler A, Müller A, Bonati L, Pfister O, Zuern C, Conen D, Kühne M, Osswald S, Swiss‐AF Investigators. Bone Morphogenetic Protein 10-A Novel Biomarker to Predict Adverse Outcomes in Patients With Atrial Fibrillation. J Am Heart Assoc 2023; 12:e028255.

Type

Journal Paper/Review (English)

Journal

J Am Heart Assoc 2023; 12

Publication Date

Mar 16, 2023

Issn Electronic

2047-9980

Pages

e028255

Brief description/objective

Background Patients with atrial fibrillation (AF) face an increased risk of death and major adverse cardiovascular events (MACE). We aimed to assess the predictive value of the novel atrial-specific biomarker BMP10 (bone morphogenetic protein 10) for death and MACE in patients with AF in comparison with NT-proBNP (N-terminal prohormone of B-type natriuretic peptide). Methods and Results BMP10 and NT-proBNP were measured in patients with AF enrolled in Swiss-AF (Swiss Atrial Fibrillation Study), a prospective multicenter cohort study. A total of 2219 patients were included (median follow-up 4.3 years [interquartile range 3.9, 5.1], mean age 73±9 years, 73% male). In multivariable Cox proportional hazard models, the adjusted hazard ratio (aHR) associated with 1 ng/mL increase of BMP10 was 1.60 (95% CI, 1.37-1.87) for all-cause death, and 1.54 (95% CI, 1.35-1.76) for MACE. For all-cause death, the concordance index was 0.783 (95% CI, 0.763-0.809) for BMP10, 0.784 (95% CI, 0.765-0.810) for NT-proBNP, and 0.789 (95% CI, 0.771-0.815) for both biomarkers combined. For MACE, the concordance index was 0.732 (95% CI, 0.715-0.754) for BMP10, 0.747 (95% CI, 0.731-0.768) for NT-proBNP, and 0.750 (95% CI, 0.734-0.771) for both biomarkers combined. When grouping patients according to NT-proBNP categories (<300, 300-900, >900 ng/L), higher aHRs were observed in patients with high BMP10 in the categories of low NT-proBNP (all-cause death aHR, 2.28 [95% CI, 1.15-4.52], MACE aHR, 1.88 [95% CI, 1.07-3.28]) and high NT-proBNP (all-cause death aHR, 1.61 [95% CI, 1.14-2.26], MACE aHR, 1.38 [95% CI, 1.07-1.80]). Conclusions BMP10 strongly predicted all-cause death and MACE in patients with AF. BMP10 provided additional prognostic information in low- and high-risk patients according to NT-proBNP stratification. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02105844.