Bone morphogenetic protein 10: a novel risk marker of ischaemic stroke in patients with atrial fibrillation.
Abstract
<h4>Aims</h4>Biomarkers specifically related to atrial tissue may increase the understanding
of the pathophysiology of atrial fibrillation (AF) and further improve risk prediction
in this setting. Bone morphogenetic protein 10 (BMP10) is a protein expressed in the
atrial myocardium. We evaluated the association between BMP10 and the risk of ischaemic
stroke and other cardiovascular events in large cohorts of patients with AF, treated
with and without oral anticoagulation (OAC).<h4>Methods and results</h4>BMP10 was
measured in plasma samples collected at randomisation in patients with AF without
OAC in the ACTIVE A and AVERROES trials (n = 2974), and with OAC in the ARISTOTLE
trial (n = 13 079). BMP10 was analysed with a prototype Elecsys immunoassay. Associations
with outcomes were evaluated by Cox-regression models adjusted for clinical characteristics,
kidney function, and N-terminal pro-B-type natriuretic peptide (NT-proBNP). Median
concentrations of BMP10 were 2.47 and 2.44 ng/mL, in the non-OAC and OAC cohort, respectively.
Increasing BMP10 was associated with lower body mass index, older age, female sex,
kidney dysfunction, and AF rhythm. BMP10 was consistently associated with ischaemic
stroke. In the non-OAC cohort, BMP10 increased the concordance index of the multivariable
model from 0.713 to 0.733 (P = 0.004) and in the OAC cohort from 0.673 to 0.694 (P
< 0.001). Additionally, BMP10 maintained a significant prognostic value after additionally
adjusting for NT-proBNP. BMP10 was not independently associated with bleeding or with
death.<h4>Conclusion</h4>The novel atrial biomarker BMP10 was independently associated
with ischaemic stroke in patients with AF irrespective of OAC treatment. BMP10 seems
to be more specifically related to the risk of ischaemic stroke in AF.<h4>One-sentence
summary</h4>In this study, BMP10 may be a novel specific biomarker of ischaemic stroke
in patients with atrial fibrillation, irrespective of oral anticoagulation.
Type
Journal articleSubject
HumansBrain Ischemia
Atrial Fibrillation
Bone Morphogenetic Proteins
Anticoagulants
Risk Factors
Female
Stroke
Biomarkers
Ischemic Stroke
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https://hdl.handle.net/10161/26516Published Version (Please cite this version)
10.1093/eurheartj/ehac632Publication Info
Hijazi, Ziad; Benz, Alexander P; Lindbäck, Johan; Alexander, John H; Connolly, Stuart
J; Eikelboom, John W; ... Wallentin, Lars (2023). Bone morphogenetic protein 10: a novel risk marker of ischaemic stroke in patients
with atrial fibrillation. European heart journal, 44(3). pp. 208-218. 10.1093/eurheartj/ehac632. Retrieved from https://hdl.handle.net/10161/26516.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
John Hunter Peel Alexander
Professor of Medicine
John H. Alexander, MD, MHS is a cardiologist and Professor of Medicine in the Department
of Medicine, Division of Cardiology at Duke University School of Medicine, as well
as the Vice Chief, Clinical Research in the Division of Cardiology. He is the Director
of Cardiovascular Research at the Duke Clinical Research Institute where he oversees
a large group of clinical research faculty and a broad portfolio of cardiovascular
clinical trials and observational clinical research programs. He is a
Christopher Bull Granger
Professor of Medicine
Research: My primary research interest is in conduct and methodology of large randomized
clinical trials in heart disease. I have led a number of large international clinical
studies in heart attacks, unstable angina, heart failure, and atrial fibrillation.
I have lead clinical studies of blood thinners and coronary intervention for heart
attacks, stroke prevention in atrial fibrillation, and prevention of heart attack
for patients with coronary artery disease. I have been co-directo
Renato Delascio Lopes
Professor of Medicine
Atrial Fibrillation Antithrombotic Therapy in patients with Acute Coronary Syndromes
Elderly patients with Heart Disease Biomarkers in Acute Coronary Syndromes and Atrial
Fibrillation Thrombosis and Anticoagulation and novel antithrombotic agents Metabolomics
in Cardiovascular Medicine
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