Kantonsspital St.Gallen

Insulin-like growth factor-binding protein 7 and risk of congestive heart failure hospitalization in patients with atrial fibrillation

Steffen Blum, Stefanie Aeschbacher, Pascal Meyre, Michael Kühne, Nicolas Rodondi, Jürg H Beer, Peter Ammann, Giorgio Moschovitis, Leo H Bonati, Manuel R Blum, Peter Kastner, Fiona Baguley, Christian Sticherling, Stefan Osswald, David Conen & BEAT-AF And Swiss-AF Investigators


The occurrence of congestive heart failure (CHF) hospitalization among patients with atrial fibrillation (AF) is a poor prognostic marker.

The purpose of this study was to assess whether insulin-like growth factor-binding protein 7 (IGFBP-7), a marker of myocardial damage, identifies AF patients at high risk for this complication.

We analyzed 2 prospective multicenter observational cohort studies that included 3691 AF patients. Levels of IGFBP-7 and N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured from frozen plasma samples at baseline. The primary endpoint was hospitalization for CHF. Multivariable adjusted Cox regression analyses were constructed.

Mean patient age was 69 ± 12 years, 1028 (28%) were female, and 879 (24%) had a history of CHF. The incidence per 1000 patient-years across increasing IGFBP-7 quartiles was 7, 10, 32, and 85. The corresponding multivariable adjusted hazard ratios (aHRs) (95% confidence interval [CI]) were 1.0, 1.05 (0.63-1.77), 2.38 (1.50-3.79), and 4.37 (2.72-7.04) (P for trend <.001). In a subgroup of 2812 patients without pre-existing CHF at baseline, the corresponding aHRs were 1.0, 0.90 (0.47-1.72), 1.69 (0.94-3.04), and 3.48 (1.94-6.24) (P for trend <.001). Patients with IGFBP-7 and NT-proBNP levels above the biomarker-specific median had a higher risk of incident CHF hospitalization (aHR 5.20; 3.35-8.09) compared to those with only 1 elevated marker (elevated IGFBP-7 aHR 2.17; 1.30-3.60); elevated NT-proBNP aHR 1.97; 1.17-3.33); or no elevated marker (reference).

Higher plasma levels of IGFBP-7 were strongly and independently associated with CHF hospitalization in AF patients. The prognostic information provided by IGFBP-7 was additive to that of NT-proBNP.
citation Blum S, Aeschbacher S, Meyre P, Kühne M, Rodondi N, Beer J H, Ammann P, Moschovitis G, Bonati L H, Blum M R, Kastner P, Baguley F, Sticherling C, Osswald S, Conen D, BEAT-AF And Swiss-AF Investigators . Insulin-like growth factor-binding protein 7 and risk of congestive heart failure hospitalization in patients with atrial fibrillation. Heart Rhythm 2020;.
type journal paper/review (English)
date of publishing 03-12-2020
journal title Heart Rhythm
ISSN electronic 1556-3871
PubMed 33278630
DOI 10.1016/j.hrthm.2020.11.028