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Prognostic value of interleukin-34 and interleukin-38 in patients with newly diagnosed atrial fibrillation
BACKGROUND: Interleukin (IL)-34 and IL-38 are associated with cardiovascular disease (CVD). However, their involvement in atrial fibrillation (AF) and AF-associated adverse events remains uncertain. Therefore, we aimed to investigate their association with various AF prognostic factors in a cohort s...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9868840/ https://www.ncbi.nlm.nih.gov/pubmed/36698935 http://dx.doi.org/10.3389/fcvm.2022.1072164 |
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author | Ma, Jiaxue Wu, Na Yuan, Zhiquan Chen, Yanxiu Li, Chengying Xie, Weijia Zhang, Zhihui Li, Yafei Zhong, Li |
author_facet | Ma, Jiaxue Wu, Na Yuan, Zhiquan Chen, Yanxiu Li, Chengying Xie, Weijia Zhang, Zhihui Li, Yafei Zhong, Li |
author_sort | Ma, Jiaxue |
collection | PubMed |
description | BACKGROUND: Interleukin (IL)-34 and IL-38 are associated with cardiovascular disease (CVD). However, their involvement in atrial fibrillation (AF) and AF-associated adverse events remains uncertain. Therefore, we aimed to investigate their association with various AF prognostic factors in a cohort study and assessed their predictive value for the prognosis of patients with AF. METHODS: Patients with new-onset non-valvular AF were consecutively enrolled between 2013 and 2015 at the Department of Cardiovascular Medicine of the Southwest Hospital of the Army Medical University (Third Military Medical University) in Chongqing, China. The endpoints included stroke and all-cause mortality. The baseline levels of plasma IL-34, IL-38, NT-proBNP, high-sensitivity cardiac troponin T (hs-cTnT), and GDF-15 were measured and their correlation with AF-related adverse events were analyzed in a Cox proportional-hazards regression model. The C-statistic, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to evaluate the performance of the AF prognostic models. Decision curve analysis (DCA) was used to evaluate the clinical net benefit of the original and modified models. RESULTS: A total of 299 patients with new-onset AF were enrolled. During the median follow-up time of 28 (IQR: 27, 29) months, the higher levels of IL-34 were associated with a lower risk of stroke, and the higher levels of IL-38 were associated with an increased risk of all-cause death (all adjusted P < 0.05). In addition, elevated hs-cTnT and NT-proBNP concentrations were associated with a higher risk of stroke and all-cause mortality (all adjusted P < 0.05). Furthermore, the CHA(2)DS(2)-VASc score combined with IL-38 and NT-proBNP significantly improved the C-statistic, IDI, and NRI (all P < 0.01). There was no statistically significant difference (all P > 0.05) in the discrimination power between the preference models and the ABC (age, biomarkers, and clinical history) score for the two prognostic outcomes. CONCLUSION: Our results suggested that IL-34 and IL-38 were independently associated with stroke and all-cause mortality in patients with AF. Moreover, adding IL-38 and NT-proBNP to the CHA(2)DS(2)-VASc score significantly improved its predictive ability of AF-related all-cause death. Finally, the preference model performed equally well as the ABC score in predicting AF prognosis. |
format | Online Article Text |
id | pubmed-9868840 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-98688402023-01-24 Prognostic value of interleukin-34 and interleukin-38 in patients with newly diagnosed atrial fibrillation Ma, Jiaxue Wu, Na Yuan, Zhiquan Chen, Yanxiu Li, Chengying Xie, Weijia Zhang, Zhihui Li, Yafei Zhong, Li Front Cardiovasc Med Cardiovascular Medicine BACKGROUND: Interleukin (IL)-34 and IL-38 are associated with cardiovascular disease (CVD). However, their involvement in atrial fibrillation (AF) and AF-associated adverse events remains uncertain. Therefore, we aimed to investigate their association with various AF prognostic factors in a cohort study and assessed their predictive value for the prognosis of patients with AF. METHODS: Patients with new-onset non-valvular AF were consecutively enrolled between 2013 and 2015 at the Department of Cardiovascular Medicine of the Southwest Hospital of the Army Medical University (Third Military Medical University) in Chongqing, China. The endpoints included stroke and all-cause mortality. The baseline levels of plasma IL-34, IL-38, NT-proBNP, high-sensitivity cardiac troponin T (hs-cTnT), and GDF-15 were measured and their correlation with AF-related adverse events were analyzed in a Cox proportional-hazards regression model. The C-statistic, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to evaluate the performance of the AF prognostic models. Decision curve analysis (DCA) was used to evaluate the clinical net benefit of the original and modified models. RESULTS: A total of 299 patients with new-onset AF were enrolled. During the median follow-up time of 28 (IQR: 27, 29) months, the higher levels of IL-34 were associated with a lower risk of stroke, and the higher levels of IL-38 were associated with an increased risk of all-cause death (all adjusted P < 0.05). In addition, elevated hs-cTnT and NT-proBNP concentrations were associated with a higher risk of stroke and all-cause mortality (all adjusted P < 0.05). Furthermore, the CHA(2)DS(2)-VASc score combined with IL-38 and NT-proBNP significantly improved the C-statistic, IDI, and NRI (all P < 0.01). There was no statistically significant difference (all P > 0.05) in the discrimination power between the preference models and the ABC (age, biomarkers, and clinical history) score for the two prognostic outcomes. CONCLUSION: Our results suggested that IL-34 and IL-38 were independently associated with stroke and all-cause mortality in patients with AF. Moreover, adding IL-38 and NT-proBNP to the CHA(2)DS(2)-VASc score significantly improved its predictive ability of AF-related all-cause death. Finally, the preference model performed equally well as the ABC score in predicting AF prognosis. Frontiers Media S.A. 2023-01-09 /pmc/articles/PMC9868840/ /pubmed/36698935 http://dx.doi.org/10.3389/fcvm.2022.1072164 Text en Copyright © 2023 Ma, Wu, Yuan, Chen, Li, Xie, Zhang, Li and Zhong. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Cardiovascular Medicine Ma, Jiaxue Wu, Na Yuan, Zhiquan Chen, Yanxiu Li, Chengying Xie, Weijia Zhang, Zhihui Li, Yafei Zhong, Li Prognostic value of interleukin-34 and interleukin-38 in patients with newly diagnosed atrial fibrillation |
title | Prognostic value of interleukin-34 and interleukin-38 in patients with newly diagnosed atrial fibrillation |
title_full | Prognostic value of interleukin-34 and interleukin-38 in patients with newly diagnosed atrial fibrillation |
title_fullStr | Prognostic value of interleukin-34 and interleukin-38 in patients with newly diagnosed atrial fibrillation |
title_full_unstemmed | Prognostic value of interleukin-34 and interleukin-38 in patients with newly diagnosed atrial fibrillation |
title_short | Prognostic value of interleukin-34 and interleukin-38 in patients with newly diagnosed atrial fibrillation |
title_sort | prognostic value of interleukin-34 and interleukin-38 in patients with newly diagnosed atrial fibrillation |
topic | Cardiovascular Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9868840/ https://www.ncbi.nlm.nih.gov/pubmed/36698935 http://dx.doi.org/10.3389/fcvm.2022.1072164 |
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