Insulin-Like Growth Factor-Binding Protein-7 and risk of congestive heart failure hospitalization in patients with atrial fibrillation.

Blum, Steffen; Aeschbacher, Stefanie; Meyre, Pascal; Kühne, Michael; Rodondi, Nicolas; Beer, Jürg H; Ammann, Peter; Moschovitis, Giorgio; Bonati, Leo H; Blum, Manuel R; Kastner, Peter; Baguley, Fiona; Sticherling, Christian; Osswald, Stefan; Conen, David (2020). Insulin-Like Growth Factor-Binding Protein-7 and risk of congestive heart failure hospitalization in patients with atrial fibrillation. (In Press). Heart rhythm Elsevier 10.1016/j.hrthm.2020.11.028

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BACKGROUND

The occurrence of congestive heart failure (CHF) hospitalization among patients with atrial fibrillation (AF) is a poor prognostic marker.

OBJECTIVE

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 two prospective multicenter observational cohort studies including 3,691 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 age was 69±12 years, 1,028 (28%) were females and 879 (24%) had a history of CHF. The incidence per 1,000 patient-years across increasing IGFBP-7 quartiles was 7, 10, 32 and 85. The corresponding multivariable adjusted hazard ratios (aHRs) [95%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 <0.001). In a subgroup of 2,812 patients without pre-existing CHF at baseline, the 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 <0.001). 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 one 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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine

UniBE Contributor:

Rodondi, Nicolas and Blum, Manuel

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1547-5271

Publisher:

Elsevier

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

10 Dec 2020 18:26

Last Modified:

10 Jan 2021 01:36

Publisher DOI:

10.1016/j.hrthm.2020.11.028

PubMed ID:

33278630

Uncontrolled Keywords:

Atrial fibrillation Biomarkers Heart failure IGFBP-7 epidemiology

BORIS DOI:

10.7892/boris.149516

URI:

https://boris.unibe.ch/id/eprint/149516

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