Prognostic Biomarker in AFib Is Identified

High-sensitivity cardiac troponin I (hs-TnI) may serve as a prognostic biomarker among patients with newly diagnosed atrial fibrillation (AF), according to a new study. The determination comes after the researchers found that individuals with AF who have elevated levels of hs-TnI are at greater risk for mortality.

To reach this conclusion, the researchers enrolled 2361 consecutive patients who had recently received an AF diagnosis into a retrospective, single-center registry from August 2014 to December 2016. Of these, 957 patients were selected and classified into 4 groups according to hs-TnI quartiles:

• Lowest quartile (Q1): hs-TnI level of 3.6 ng/L or less 
• Second quartile (Q2): hs-TnI level more than 3.6 ng/L to 10.1 ng/L or less
• Third quartile (Q3): hs-TnI level more than 10.1 ng/L to 22.0 ng/L or less 
• Highest quartile (Q4): hs-TnI more than 22.0 ng/L 

All-cause mortality during the median 19.3 months of follow-up was the primary outcome.

According to the study authors, patients in Q4 had a higher risk of all-cause mortality, as well as for readmission for heart failure and readmission for revascularization, compared with patients in Q1.

Renal insufficiency, highest hs-TnI quartile, and anticoagulation therapy were all independent predictors of all-cause mortality.

“Elevated hs-TnI is independently associated with higher mortality in patients with AF and serves as a valuable prognostic biomarker in patients with newly detected AF,” the researchers concluded.

—Colleen Murphy

Reference:

Kim BS, Kwon CH, Chang H, et al. Usefulness of high-sensitivity troponin I to predict outcome in patients with newly detected atrial fibrillation. Am J Cardiol. 2020;125(5):744-750. https://doi.org/10.1016/j.amjcard.2019.12.004.