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A Circulating Biomarker Risk-Prediction Model Correlates with CHADS-2 Risk Score in Chronic Atrial Fibrillation.

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Citation: IJC Metabolic & Endocrine. 6:24-26, 2015 MarPMID: 25709897Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: PubMed-not-MEDLINE -- Not indexedYear: 2015 ISSN:

2214-7624

Name of journal: IJC metabolic & endocrineAbstract: BACKGROUND: Inflammation and oxidative stress have been linked to the origin and persistence of atrial fibrillation (AF). CHADS-2 scoring system is a risk stratification schema well validated in prognostication of stroke in AF. We evaluated the association of markers of oxidative stress and inflammation with CHADS-2 scores in chronic AF patients.CONCLUSIONS: A biomarker risk-model using a combination of hs-CRP and DROMs correlates well with CHADS-2 risk scores in chronic AF. Either or both of these markers may add predictive power to future stroke risk prediction models.METHODS: CHADS-2 scores were calculated for 64 subjects with chronic AF. Serum markers of inflammation [C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin 1beta (IL-1beta), tumor necrosis factor-alpha (TNF-alpha)] and of oxidative stress [Derivatives of reactive oxygen metabolites (DROMs) and isoprostanes (IsoPs)] were measured.RESULTS: Twenty subjects were categorized as 0 (no risk), 24 as 1 (intermediate risk) and 20 as 2 (severe risk) based on their CHADS-2 scores. High sensitivity-CRP (CHADS-2 0=40.0%, 1=70.0%, 2=90.0%; p=0.003) and DROMs (CHADS-2 0=45%, 1=78%, 2=80%; p=0.04) were positively associated with the CHADS-2 risk score. Subjects with intermediate to severe CHADS-2 risk retained significant associations with abnormal hs-CRP (OR: 5.3, 95%CI: 1.1-25.0) and DROMs (adjusted OR: 6.7, 95%CI: 1.2-38.8) after adjusting for gender and hypertension. In a multiple logistic interaction model, there was no significant interaction between hs-CRP and DROMs in their association with CHADS-2 risk categories (p=0.64). A biomarker risk-model, combining hs-CRP and DROMs, correlated well with the CHADS-2 risk categories (r= 0.49, p<0.001).All authors: Anand A, Dudley SC Jr, Greener I, Negi SIFiscal year: FY2015Digital Object Identifier:

https://dx.doi.org/10.1016/j.ijcme.2015.01.002

Date added to catalog: 2018-01-18

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Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	25709897	Available		25709897

BACKGROUND: Inflammation and oxidative stress have been linked to the origin and persistence of atrial fibrillation (AF). CHADS-2 scoring system is a risk stratification schema well validated in prognostication of stroke in AF. We evaluated the association of markers of oxidative stress and inflammation with CHADS-2 scores in chronic AF patients.

CONCLUSIONS: A biomarker risk-model using a combination of hs-CRP and DROMs correlates well with CHADS-2 risk scores in chronic AF. Either or both of these markers may add predictive power to future stroke risk prediction models.

METHODS: CHADS-2 scores were calculated for 64 subjects with chronic AF. Serum markers of inflammation [C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin 1beta (IL-1beta), tumor necrosis factor-alpha (TNF-alpha)] and of oxidative stress [Derivatives of reactive oxygen metabolites (DROMs) and isoprostanes (IsoPs)] were measured.

RESULTS: Twenty subjects were categorized as 0 (no risk), 24 as 1 (intermediate risk) and 20 as 2 (severe risk) based on their CHADS-2 scores. High sensitivity-CRP (CHADS-2 0=40.0%, 1=70.0%, 2=90.0%; p=0.003) and DROMs (CHADS-2 0=45%, 1=78%, 2=80%; p=0.04) were positively associated with the CHADS-2 risk score. Subjects with intermediate to severe CHADS-2 risk retained significant associations with abnormal hs-CRP (OR: 5.3, 95%CI: 1.1-25.0) and DROMs (adjusted OR: 6.7, 95%CI: 1.2-38.8) after adjusting for gender and hypertension. In a multiple logistic interaction model, there was no significant interaction between hs-CRP and DROMs in their association with CHADS-2 risk categories (p=0.64). A biomarker risk-model, combining hs-CRP and DROMs, correlated well with the CHADS-2 risk categories (r= 0.49, p<0.001).

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