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Serum NOX2 and urinary isoprostanes predict vascular events in patients with atrial fibrillation
- Source :
- Thrombosis and Haemostasis. 113:617-624
- Publication Year :
- 2015
- Publisher :
- Georg Thieme Verlag KG, 2015.
-
Abstract
- SummaryThere are limited prospective data evaluating the role of urinary F2-IsoP and NOX2 as predictive markers in atrial fibrillation (AF). The aim of this study was to analyse the role of urinary prostaglandin PGF2alpha (8-iso-PGF2α) and NOX2, markers of systemic oxidative stress, in predicting cardiovascular (CV) events and mortality in anticoagulated non-valvular AF patients. This was a prospective study including 1,002 anticoagulated AF patients, followed for a median time of 25.7 months (interquartile range: 14.8–50.9). All major CV events, CV deaths and all-cause deaths were considered as primary outcomes of the study. CV events included fatal/nonfatal ischaemic stroke, fatal/ nonfatal myocardial infarction (MI), cardiac revascularisation and transient ischaemic attack (TIA). Oxidative stress biomarkers, such as urinary 8-iso-PGF2α and serum sNOX2-dp, a marker of NOX2 activation, were measured. A CV event occurred in 125 patients (12.5 %); 78 CV deaths and 31 non-CV deaths were registered. 8-iso-PGF2α and sNOX2-dp were correlated (Rs=0.765 p> 0.001). A significant increased cumulative incidence of CV events and CV deaths was observed across tertiles for 8-iso-PGF2α and sNOX2-dp. An increased rate of all-cause death was observed across tertiles of urinary 8-iso-PGF2α.In Cox or Fine and Gray models, 8-iso-PGF2α predicted CV events and CV and non-CV deaths. The addition of tertiles of 8-iso-PGF2α to CHA2DS2-VASc score improved ROC curves for each outcome and NRI for CV events (0.24 [0.06–0.53] p=0.0067). The study shows that in AF patients 8-iso-PGF2α and NOX2 levels are predictive of CV events and total mortality. F2-IsoP may complement conventional risk factors in prediction of CV events.Note: The review process for this manuscript was fully handled by Christian Weber, Editor in Chief. Clinical Trial Registration: ClinicalTrials.gov NCT01882114.
- Subjects :
- Male
0301 basic medicine
Time Factors
Rome
Myocardial Infarction
Kaplan-Meier Estimate
030204 cardiovascular system & hematology
Dinoprost
medicine.disease_cause
Brain Ischemia
0302 clinical medicine
Risk Factors
Interquartile range
Cause of Death
Ischaemic stroke
atrial fibrillation
Prospective Studies
Myocardial infarction
Prospective cohort study
Aged, 80 and over
Membrane Glycoproteins
Incidence
Atrial fibrillation
Hematology
Middle Aged
Stroke
Ischemic Attack, Transient
Area Under Curve
NADPH Oxidase 2
Cardiology
Female
urinary isoprostanes
Settore SECS-S/01 - Statistica
medicine.medical_specialty
Urinary system
arrhythmia
cardiovascular events
03 medical and health sciences
NOX2
Predictive Value of Tests
Internal medicine
medicine
Humans
In patient
Aged
Proportional Hazards Models
business.industry
NADPH Oxidases
medicine.disease
Cerebrovascular Disorders
Oxidative Stress
030104 developmental biology
ROC Curve
business
Biomarkers
Oxidative stress
Subjects
Details
- ISSN :
- 2567689X and 03406245
- Volume :
- 113
- Database :
- OpenAIRE
- Journal :
- Thrombosis and Haemostasis
- Accession number :
- edsair.doi.dedup.....c1bc5c5c971d412ea00d14eb872d3229
- Full Text :
- https://doi.org/10.1160/th14-07-0571