Hennings, ElisaElisaHenningsBlum, SteffenSteffenBlumAeschbacher, StefanieStefanieAeschbacherCoslovsky, MichaelMichaelCoslovskyKnecht, SvenSvenKnechtEken, CeylanCeylanEkenLischer, MirkoMirkoLischerPaladini, Rebecca ERebecca EPaladiniKrisai, PhilippPhilippKrisaiReichlin, Tobias RomanTobias RomanReichlin0000-0002-7197-8415Rodondi, NicolasNicolasRodondiBeer, Jürg HJürg HBeerAmmann, PeterPeterAmmannConte, GiulioGiulioConteDe Perna, Maria LuisaMaria LuisaDe PernaKobza, RichardRichardKobzaBlum, ManuelManuelBlum0000-0003-4638-775XBossard, MatthiasMatthiasBossardKastner, PeterPeterKastnerZiegler, AndréAndréZieglerMüller, ChristianChristianMüllerBonati, Leo HLeo HBonatiPfister, OtmarOtmarPfisterZuern, Christine SChristine SZuernConen, DavidDavidConenKühne, MichaelMichaelKühneOsswald, StefanStefanOsswald2024-10-252024-10-252023-03-21https://boris-portal.unibe.ch/handle/20.500.12422/165336Background Patients with atrial fibrillation (AF) face an increased risk of death and major adverse cardiovascular events (MACE). We aimed to assess the predictive value of the novel atrial-specific biomarker BMP10 (bone morphogenetic protein 10) for death and MACE in patients with AF in comparison with NT-proBNP (N-terminal prohormone of B-type natriuretic peptide). Methods and Results BMP10 and NT-proBNP were measured in patients with AF enrolled in Swiss-AF (Swiss Atrial Fibrillation Study), a prospective multicenter cohort study. A total of 2219 patients were included (median follow-up 4.3 years [interquartile range 3.9, 5.1], mean age 73±9 years, 73% male). In multivariable Cox proportional hazard models, the adjusted hazard ratio (aHR) associated with 1 ng/mL increase of BMP10 was 1.60 (95% CI, 1.37-1.87) for all-cause death, and 1.54 (95% CI, 1.35-1.76) for MACE. For all-cause death, the concordance index was 0.783 (95% CI, 0.763-0.809) for BMP10, 0.784 (95% CI, 0.765-0.810) for NT-proBNP, and 0.789 (95% CI, 0.771-0.815) for both biomarkers combined. For MACE, the concordance index was 0.732 (95% CI, 0.715-0.754) for BMP10, 0.747 (95% CI, 0.731-0.768) for NT-proBNP, and 0.750 (95% CI, 0.734-0.771) for both biomarkers combined. When grouping patients according to NT-proBNP categories (<300, 300-900, >900 ng/L), higher aHRs were observed in patients with high BMP10 in the categories of low NT-proBNP (all-cause death aHR, 2.28 [95% CI, 1.15-4.52], MACE aHR, 1.88 [95% CI, 1.07-3.28]) and high NT-proBNP (all-cause death aHR, 1.61 [95% CI, 1.14-2.26], MACE aHR, 1.38 [95% CI, 1.07-1.80]). Conclusions BMP10 strongly predicted all-cause death and MACE in patients with AF. BMP10 provided additional prognostic information in low- and high-risk patients according to NT-proBNP stratification. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02105844.enBMP10 MACE atrial fibrillation bone morphogenetic protein 10 death600 - Technology::610 - Medicine & health300 - Social sciences, sociology & anthropology::360 - Social problems & social servicesarticle10.48350/1803063692693910.1161/JAHA.122.028255