Why the study?
Do biomarker-based risk scores improve risk stratification for stroke and bleeding in patients with atrial fibrillation compared to traditional clinical scores?
Do biomarker-based risk scores improve risk stratification for stroke and bleeding in patients with atrial fibrillation compared to traditional clinical scores?
Biomarker-based risk scores, such as the ABC-stroke and ABC-bleeding scores, offer improved risk stratification for thromboembolic and bleeding events in patients with atrial fibrillation compared to traditional clinical scores.
May refine AF risk stratification; leaves open prospective validation before practice change.
Patients with AF undergo progressive cardiac structural remodeling, which may precede the onset of the arrhythmia. Abnormal concentrations of circulating biomarkers reflecting the underlying pathophysiologic mechanisms of hemodynamic stress (i.e., natriuretic peptides), inflammation (i.e., C-reactive protein), and myocardial fibrosis identify patients at higher risk of developing AF. Circulating biomarkers can also be used to identify patients with AF who are at greatest risk for developing S/SEE or major bleeding. In particular, biomarkers of hemodynamic stress, myocardial injury (i.e., cardiac troponin), and coagulation activity (i.e., D-dimer) are key indicators of thromboembolic risk, and cardiac troponin and growth-differentiation factor-15 are strongly associated with risk of anticoagulant-related major bleeding. The biomarker-based age, biomarker, clinical history (ABC)-stroke and ABC-bleeding risk scores improve risk stratification for S/SEE and major bleeding, respectively, when compared with traditional clinical risk scores like the CHA2DS2-VASc and HAS-BLED scores.
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Berg et al. (2020) studied this question.
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