Abstract 12613: High-sensitivity Troponin-I is Predictive of Incident Atrial Fibrillation in a High-Risk Patient Population
Bibliographic record
Abstract
Introduction: Biomarkers have been linked to incident atrial fibrillation (AF) in the general population. We evaluated the association between several biomarkers previously shown to be predictors of death and myocardial infarction (MI), and development of AF in a high-risk patient population with CAD. Hypothesis: Biomarkers will predict new-onset AF in a population with CAD. Methods: 2773 patients (age 62±13 years) with known or suspected CAD were enrolled in the Emory Cardiovascular Biobank. Circulating levels of high-sensitivity troponin I (hs-TnI), fibrin degradation products (FDP), c-reactive protein (CRP), soluble urokinase-type plasminogen activator receptor (suPAR), and heat shock protein 70 (HSP70) were measured with ELISA. Biomakers were dichotomized into high or low levels by median, as well as into quartiles. Cox proportional hazard models were used to investigate the associations between biomarkers and incident AF after adjustment for age, sex, race, body mass index (BMI), smoking history, hypertension, diabetes, hyperlipidemia, history of MI, CAD severity by Gensini score, estimated glomerular filtration rate, and use of ACE inhibitors/ARBs/statins. Results: During a median 5.75 years of follow-up, 423 (15.3%) patients developed AF. Subjects with incident AF were older, had higher BMI, greater CAD severity, lower eGFR, and more often had prior MI. Elevated levels of hs-TnI (≥median 4.7 pg/mL) were associated with incident AF (hazard ratio (HR) 2.00, [95% confidence interval (CI) 1.60-2.51], P<0.001), that remained significant after adjustment for the aforementioned covariates (HR 1.75, 95%CI 1.33-2.31, P<0.0001). The findings were supported by quartile analysis when comparing the first quartile to the fourth quartile (HR 1.82, 95% CI 1.23-2.70, p=0.003 after adjustment). FDP, suPAR, CRP, and HSP70 were not associated with incident AF after adjustment for covariates. Conclusions: In subjects with CAD, higher hs-TnI levels are associated with incident AF even after adjustment for severity of CHD. Risk stratification for incident AF may permit institution of more aggressive risk factor modification and targeted screening.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".