Abstract
Aims: The clinical correlates and consequences of atrial fibrillation (AF) might be different between heart failure with reduced vs. preserved ejection fraction (HFrEF vs. HFpEF). Biomarkers may provide insights into underlying pathophysiological mechanisms of AF in these different heart failure (HF) phenotypes. Methods and results: We performed a retrospective analysis of the BIOlogy Study to TAilored Treatment in Chronic Heart Failure (BIOSTAT-CHF), which was an observational cohort. We studied 2152 patients with HFrEF [ejection fraction (EF < 40%)], of which 1419 were in sinus rhythm (SR) and 733 had AF. Another 524 patients with HFpEF (EF ≥50%) were studied, of which 286 in SR and 238 with AF. For the comparison of biomarker profiles, 92 cardiovascular risk markers were measured (Proseek® Olink Cardiovascular III panel). The circulating risk marker pattern observed in HFrEF was different than the pattern in HFpEF: in HFrEF, AF was associated with higher levels of 77 of 92 (84%) risk markers compared to SR; whereas in HFpEF, many more markers were higher in SR than in AF. Over a median follow-up of 21 months, AF was associated with increased mortality risk [multivariable hazard ratio (HR) of 1.27; 95% confidence interval (CI) 1.09-1.48, P = 0.002]; there was no significant interaction between heart rhythm and EF group on outcome. Conclusion: In patients with HFrEF, the presence of AF was associated with a homogeneously elevated cardiovascular risk marker profile. In contrast, in patients with HFpEF, the presence of AF was associated with a more scattered risk marker profile, suggesting differences in underlying pathophysiological mechanisms of AF in these HF phenotypes.
| Original language | English |
|---|---|
| Pages (from-to) | 3867-3875 |
| Number of pages | 9 |
| Journal | European Heart Journal |
| Volume | 39 |
| Issue number | 43 |
| Early online date | 22 Aug 2018 |
| DOIs | |
| Publication status | Published - 14 Nov 2018 |
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Keywords
- Atrial fibrillation
- Heart failure
- Preserved ejection fraction
- Biomarkers
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Comparing biomarker profiles of patients with heart failure : atrial fibrillation vs. sinus rhythm and reduced vs. preserved ejection fraction. / Santema, Bernadet T.; Kloosterman, Marielle; Van Gelder, Isabelle C.; Mordi, Ify; Lang, Chim; Lam, Carolyn S. P.; Anker, Stefan D.; Cleland, John G. F.; Dickstein, Kenneth; Filippatos, Gerasimos S.; van der Harst, Pim; Hillege, Hans L.; ter Maaten, Jozine M.; Metra, Marco; Ng, Leong Loke; Ponikowski, Piotr; Samani, Nilesh J.; van Veldhuisen, Dirk Jan; Zwinderman, Aeilko H.; Zannad, Faiez; Damman, Kevin; van der Meer, Peter; Rienstra, Michiel; Voors, Adriaan A. (Lead / Corresponding author).
In: European Heart Journal, Vol. 39, No. 43, 14.11.2018, p. 3867-3875.Research output: Contribution to journal › Article
TY - JOUR
T1 - Comparing biomarker profiles of patients with heart failure
T2 - atrial fibrillation vs. sinus rhythm and reduced vs. preserved ejection fraction
AU - Santema, Bernadet T.
AU - Kloosterman, Marielle
AU - Van Gelder, Isabelle C.
AU - Mordi, Ify
AU - Lang, Chim
AU - Lam, Carolyn S. P.
AU - Anker, Stefan D.
AU - Cleland, John G. F.
AU - Dickstein, Kenneth
AU - Filippatos, Gerasimos S.
AU - van der Harst, Pim
AU - Hillege, Hans L.
AU - ter Maaten, Jozine M.
AU - Metra, Marco
AU - Ng, Leong Loke
AU - Ponikowski, Piotr
AU - Samani, Nilesh J.
AU - van Veldhuisen, Dirk Jan
AU - Zwinderman, Aeilko H.
AU - Zannad, Faiez
AU - Damman, Kevin
AU - van der Meer, Peter
AU - Rienstra, Michiel
AU - Voors, Adriaan A.
N1 - Netherlands Cardiovascular Research Initiative: an initiative with support of the Dutch Heart Foundation; Renal Connection to microvascular disease and heart failure with preserved ejection fraction (CVON2014-11 RECONNECT); and European Commission (FP7-242209-BIOSTAT-CHF; EudraCT 2010–020808–29); NHS Education for Scotland/Chief Scientist Office Postdoctoral Clinical Lectureship (PCL/17/07 to I.M.).
PY - 2018/11/14
Y1 - 2018/11/14
N2 - Aims: The clinical correlates and consequences of atrial fibrillation (AF) might be different between heart failure with reduced vs. preserved ejection fraction (HFrEF vs. HFpEF). Biomarkers may provide insights into underlying pathophysiological mechanisms of AF in these different heart failure (HF) phenotypes. Methods and results: We performed a retrospective analysis of the BIOlogy Study to TAilored Treatment in Chronic Heart Failure (BIOSTAT-CHF), which was an observational cohort. We studied 2152 patients with HFrEF [ejection fraction (EF < 40%)], of which 1419 were in sinus rhythm (SR) and 733 had AF. Another 524 patients with HFpEF (EF ≥50%) were studied, of which 286 in SR and 238 with AF. For the comparison of biomarker profiles, 92 cardiovascular risk markers were measured (Proseek® Olink Cardiovascular III panel). The circulating risk marker pattern observed in HFrEF was different than the pattern in HFpEF: in HFrEF, AF was associated with higher levels of 77 of 92 (84%) risk markers compared to SR; whereas in HFpEF, many more markers were higher in SR than in AF. Over a median follow-up of 21 months, AF was associated with increased mortality risk [multivariable hazard ratio (HR) of 1.27; 95% confidence interval (CI) 1.09-1.48, P = 0.002]; there was no significant interaction between heart rhythm and EF group on outcome. Conclusion: In patients with HFrEF, the presence of AF was associated with a homogeneously elevated cardiovascular risk marker profile. In contrast, in patients with HFpEF, the presence of AF was associated with a more scattered risk marker profile, suggesting differences in underlying pathophysiological mechanisms of AF in these HF phenotypes.
AB - Aims: The clinical correlates and consequences of atrial fibrillation (AF) might be different between heart failure with reduced vs. preserved ejection fraction (HFrEF vs. HFpEF). Biomarkers may provide insights into underlying pathophysiological mechanisms of AF in these different heart failure (HF) phenotypes. Methods and results: We performed a retrospective analysis of the BIOlogy Study to TAilored Treatment in Chronic Heart Failure (BIOSTAT-CHF), which was an observational cohort. We studied 2152 patients with HFrEF [ejection fraction (EF < 40%)], of which 1419 were in sinus rhythm (SR) and 733 had AF. Another 524 patients with HFpEF (EF ≥50%) were studied, of which 286 in SR and 238 with AF. For the comparison of biomarker profiles, 92 cardiovascular risk markers were measured (Proseek® Olink Cardiovascular III panel). The circulating risk marker pattern observed in HFrEF was different than the pattern in HFpEF: in HFrEF, AF was associated with higher levels of 77 of 92 (84%) risk markers compared to SR; whereas in HFpEF, many more markers were higher in SR than in AF. Over a median follow-up of 21 months, AF was associated with increased mortality risk [multivariable hazard ratio (HR) of 1.27; 95% confidence interval (CI) 1.09-1.48, P = 0.002]; there was no significant interaction between heart rhythm and EF group on outcome. Conclusion: In patients with HFrEF, the presence of AF was associated with a homogeneously elevated cardiovascular risk marker profile. In contrast, in patients with HFpEF, the presence of AF was associated with a more scattered risk marker profile, suggesting differences in underlying pathophysiological mechanisms of AF in these HF phenotypes.
KW - Atrial fibrillation
KW - Heart failure
KW - Preserved ejection fraction
KW - Biomarkers
UR - http://www.scopus.com/inward/record.url?scp=85056672463&partnerID=8YFLogxK
U2 - 10.1093/eurheartj/ehy421
DO - 10.1093/eurheartj/ehy421
M3 - Article
VL - 39
SP - 3867
EP - 3875
JO - European Heart Journal
JF - European Heart Journal
SN - 0195-668X
IS - 43
ER -