Heart Failure -> Heart Failure Management: -> Monitoring D-AB14 - Atrial Fibrillation in Heart Failure (ID 43) Abstract Plus

D-AB14-02 - Insulin-like Growth Factor-binding Protein-7 And N-terminal Pro-brain Natriuretic Peptide To Predict Congestive Heart Failure Hospitalizations In Patients With Atrial Fibrillation (ID 1435)


Background: Congestive heart failure (CHF) has become the most common cardiovascular complication in patients with atrial fibrillation (AF). Accurately predicting CHF in AF patients is a clear unmet clinical need.
Objective: To assess the individual and combined value of Insulin-Like Growth Factor-Binding Protein-7 (IGFBP-7) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in identifying AF patients at risk for CHF.
Methods: We analyzed 3,691 prospectively followed AF patients. Information on demographics and co-morbidities were obtained through standardized questionnaires. Levels of IGFBP-7 and NT-proBNP were measured at baseline. Multivariable adjusted Cox-regression analyses were constructed to assess the associations of IGFBP-7 and NT-proBNP levels with CHF.
Results: Mean age was 69±12 years, 1,028 (28%) were women and 879 (24%) had a history of CHF. During 3.7±1.8 years, 385 patients were hospitalized for CHF. The incidence per 1,000 patient-years was 7, 10, 32 and 85 across increasing IGFBP-7 quartiles and 3, 15, 34 and 81 across increasing NT-proBNP quartiles, respectively. Patients with IGFBP-7 and NT-proBNP concentration levels above the biomarker specific median had a higher risk of incident CHF (multivariable adjusted hazard ratio [aHR] 5.87 [95%CI 3.78;9.12]) compared to those with only one of two elevated marker (elevated IGFBP-7 aHR 2.26 [95%CI 1.36;3.75]; elevated NT-proBNP aHR 2.09 [95%CI 1.24;3.54]) or no elevated marker (ref.) [Figure].
Conclusion: IGFBP-7 and NT-proBNP provide strong and additive information in the prediction of CHF among patients with AF. These markers may be helpful to identify AF patients at very high risk of CHF.