A panel of 5 circulating biomarkers independently predicted cardiovascular death, stroke, myocardial infarction, and systemic embolism, significantly enhancing predictive accuracy in AF patients.
Observational (n=3,817)
Does a panel of circulating biomarkers improve risk prediction for adverse cardiovascular outcomes in patients with atrial fibrillation compared to established clinical risk scores?
Integrating a panel of circulating biomarkers into conventional and machine learning models improves risk stratification for adverse cardiovascular and bleeding events in patients with atrial fibrillation.
Atrial fibrillation (AF) increases the risk of adverse cardiovascular events, yet the underlying biological mechanisms remain unclear. We evaluate a panel of 12 circulating biomarkers representing diverse pathophysiological pathways in 3817 AF patients to assess their association with adverse cardiovascular outcomes. We identify 5 biomarkers including D-dimer, growth differentiation factor 15 (GDF-15), interleukin-6 (IL-6), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and high-sensitivity troponin T (hsTropT) that independently predict cardiovascular death, stroke, myocardial infarction, and systemic embolism, significantly enhancing predictive accuracy. Additionally, GDF-15, insulin-like growth factor-binding protein-7 (IGFBP-7), NT-proBNP, and hsTropT predict heart failure hospitalization, while GDF-15 and IL-6 are associated with major bleeding events. A biomarker model improves predictive accuracy for stroke and major bleeding compared to established clinical risk scores. Machine learning models incorporating these biomarkers demonstrate consistent improvements in risk stratification across most outcomes. In this work, we show that integrating biomarkers related to myocardial injury, inflammation, oxidative stress, and coagulation into both conventional and machine learning-based models refine prognosis and guide clinical decision-making in AF patients.
Braun-Meyre et al. (2025) conducted an observational in Atrial fibrillation (n=3,817). Circulating biomarker panels vs. Established clinical risk scores was evaluated on Cardiovascular death, stroke, myocardial infarction, and systemic embolism. A panel of 5 circulating biomarkers independently predicted cardiovascular death, stroke, myocardial infarction, and systemic embolism, significantly enhancing predictive accuracy in AF patients.