Association of sST2 and hs-CRP levels with new-onset atrial fibrillation in coronary artery disease

Background: The data on biomarkers as predictors of atrial fibrillation (AF) in patients with coronary artery disease (CAD) are limited. Methods: A total of 1946 patients with CAD were recruited to the ARTEMIS study. At baseline, the study patients underwent clinical and echocardiographic examinations and had laboratory tests. The patients (n = 1710) with the information about the occurrence of new-onset AF during the follow-up were included in the present analysis. Results: During 5.7 +/- 1.5 years of follow-up, 143 (8.4%) patients developed a new-onset AF. Higher values of soluble ST2 (sST2) (20.2 +/- 10.8 vs. 17.5 +/- 7.2 ng/mL, p = 0.005), high-sensitivity troponin T (hs-TnT) (11.9 +/- 10.2 vs. 10.3 +/- 8.3 ng/L, p = 0.005), high-sensitivity C-reactive protein (hs-CRP) (3.3 +/- 5.9 vs. 2.0 +/- 4.4 mg/L, p < 0.001) and brain natriuretic peptide (BNP) (85.6 +/- 77.5 vs. 64.9 +/- 73.5 ng/L, p b 0.001) had significant associations with the occurrence of new-onset AF. In the Cox clinical hazards model, higher age (p = 0.004), greater weight (p = 0.045), larger left atrial diameter (p = 0.001), use of asthma/chronic obstructive pulmonary disease medication (p = 0.001) and lack of cholesterol lowering medication (p = 0.008) had a significant associationwith the increased risk of AF. When the biomarkers were tested in the Cox clinical hazards model, sST2 (HR = 1.025, 95% CI = 1.007-1.043, p = 0.006) and hs-CRP (HR = 1.027, 95% CI = 1.008-1.047, p = 0.006) retained their significant power in predicting AF. Conclusion: Abiomarkerof fibrosis, sST2, and a biomarker of inflammation, hs-CRP, predict the risk of occurrence of new-onset AF in patients with CAD. These biomarkers contributed to the discrimination of the AF risk model, but did not improve it markedly. (C) 2017 Elsevier B.V. All rights reserved.