The addition of blood tests for two biomarkers improves the accuracy of a test used to decide whether people with an irregular heartbeat, known as atrial fibrillation, need to take anticoagulant medication to reduce their risk for stroke.
“Stroke risk scores, such as the guideline-recommended CHA2DS2-VASc score, are widely used to assist decision making for anticoagulation in atrial fibrillation,” write lead author Mary Cushman, MD, a professor at the University of Vermont, and colleagues in the Journal of Thrombosis and Haemostasis.
“While this approach has transformed clinical practice, the decision to recommend anticoagulation to patients with atrial fibrillation remains difficult as current risk tools have substantial limitations.”
The researchers set out to discover if adding certain biomarker blood tests to medical assessment of patients with atrial fibrillation could better predict their risk for future stroke.
The study assessed people who developed stroke in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Of 30,239 participants, 2411 had atrial fibrillation and 163 developed stroke over a period of 13 years.
Overall, nine biomarker tests were carried out and assessed, with additional supporting results published in a linked study published concurrently in the same journal. Higher levels of the biomarkers N-terminal pro-B-type natriuretic peptide, growth differentiation factor 15, cystatin C, interleukin 6, and lipoprotein(a) were all linked with higher stroke risk after adjusting for confounding factors.
The researchers also assessed whether they could use their results to improve the accuracy of the existing CHA2DS2-VASc score. They found that adding the biomarkers N-terminal pro-B-type natriuretic peptide and growth differentiation factor 15 to the model led to the best results and they released a link to a new online CHA2DS2-VASc Biomarkers calculator.
“This could be a game-changer for stroke prevention,” said Cushman in a press statement. “We’re giving physicians a sharper tool to provide a personalized approach to anticoagulation for patients who need it most, while sparing others from unnecessary risk.”