title: Relation between soluble ST2, growth differentiation factor-15, and high-sensitivity troponin I and incident atrial fibrillation.
abstract: BACKGROUND
  We investigated whether circulating concentrations of soluble ST2, growth differentiation factor-15 (GDF-15), and high-sensitivity troponin I (hsTnI) are associated with incident atrial fibrillation (AF) and whether these biomarkers improve current risk prediction models including AF risk factors, B-type natriuretic peptide (BNP), and C-reactive protein (CRP).
  
  
  METHODS
  We studied the relation between soluble ST2, GDF-15, and hsTnI and development of AF in Framingham Heart Study participants without prevalent AF. We used Cox proportional hazard regression analysis to examine the relation of incident AF during a 10-year follow-up period with each biomarker. We adjusted for standard AF clinical risk factors, BNP, and CRP.
  
  
  RESULTS
  The mean age of the 3,217 participants was 59 ± 10 years, and 54% were women. During a 10-year follow-up, 242 participants developed AF. In age- and sex-adjusted models, GDF-15 and hsTnI were associated with risk of incident AF; however, after including the AF risk factors and BNP and CRP, only hsTnI was significantly associated with AF (hazard ratio per 1 SD of loge hsTnI, 1.12, 95% CI 1.00-1.26, P = .045). The c statistic of the base model including AF risk factors, BNP, and CRP was 0.803 (95% CI 0.777-0.830) and did not improve by adding individual or all 3 biomarkers. None of the discrimination and reclassification statistics were significant compared with the base model.
  
  
  CONCLUSIONS
  In a community-based cohort, circulating hsTnI concentrations were associated with incident AF. None of the novel biomarkers evaluated improved AF risk discrimination or reclassification beyond standard clinical AF risk factors and biomarkers.
authors: Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA; Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA. Electronic address: m.rienstra@umcg.nl.
authors: Michiel
authors: M
authors: Rienstra
authors: National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA; Department of Mathematics and Statistics, Boston University, Boston, MA.
authors: Xiaoyan
authors: X
authors: Yin
authors: National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA; Department of Mathematics and Statistics, Boston University, Boston, MA.
authors: Martin G
authors: MG
authors: Larson
authors: National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA; Section of Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA.
authors: João D
authors: JD
authors: Fontes
authors: National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA; Section of Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA.
authors: Jared W
authors: JW
authors: Magnani
authors: Department of Medicine, Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, MA.
authors: David D
authors: DD
authors: McManus
authors: Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors: Elizabeth L
authors: EL
authors: McCabe
authors: Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Cardiology Division, Loyola University, Chicago, IL.
authors: Erin E
authors: EE
authors: Coglianese
authors: Department of Medicine, Newark Beth Israel Medical Center, Newark, NJ.
authors: Michael
authors: M
authors: Amponsah
authors: National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA; Section of Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA.
authors: Jennifer E
authors: JE
authors: Ho
authors: Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors: James L
authors: JL
authors: Januzzi
authors: Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
authors: Kai C
authors: KC
authors: Wollert
authors: Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors: Michael G
authors: MG
authors: Fradley
authors: National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA; Section of Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA; Department of Preventive Medicine, Boston University School of Medicine, Boston, MA; Department of Epidemiology, Boston University School of Public Health, Boston, MA.
authors: Ramachandran S
authors: RS
authors: Vasan
authors: Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA; Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors: Patrick T
authors: PT
authors: Ellinor
authors: National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA; Division of Cardiovascular Medicine, Vanderbilt University, Nashville, TN.
authors: Thomas J
authors: TJ
authors: Wang
authors: National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA; Section of Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA; Department of Preventive Medicine, Boston University School of Medicine, Boston, MA; Department of Epidemiology, Boston University School of Public Health, Boston, MA.
authors: Emelia J
authors: EJ
authors: Benjamin
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood* / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000235:genetics*; D005260:Female; D055436:Growth Differentiation Factor 15 / Q000097:blood*; D006801:Humans; D000072179:Interleukin-1 Receptor-Like 1 Protein; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000235:genetics*; D016016:Proportional Hazards Models; D011956:Receptors, Cell Surface / Q000097:blood*; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D015415:Biomarkers; C526140:GDF15 protein, human; D055436:Growth Differentiation Factor 15; C079241:IL1RL1 protein, human; D000072179:Interleukin-1 Receptor-Like 1 Protein; D011956:Receptors, Cell Surface; D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein