Evidence map›Paper›PMID 40839563›Full record

ArticlePloS one2025

Improvement in risk prediction for patients with atrial fibrillation and intermediate-risk CHA2DS2-VASc score utilizing highly sensitive cardiac troponin T.

Christian Salbach, Mustafa Yildirim, Barbara Ruth Milles, Hauke Hund, Matthias Mueller-Hennessen, Norbert Frey, Hugo Katus, Evangelos Giannitsis

Abstract read
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Christian SalbachDepartment of Internal Medicine III, Cardiology, University Hospital of Heidelberg, Heidelberg, Germany.ORCID https://orcid.org/0000-0002-1799-545X
Mustafa YildirimDepartment of Internal Medicine III, Cardiology, University Hospital of Heidelberg, Heidelberg, Germany.
Barbara Ruth MillesDepartment of Internal Medicine III, Cardiology, University Hospital of Heidelberg, Heidelberg, Germany.ORCID https://orcid.org/0009-0004-4602-5489
Hauke HundDepartment of Internal Medicine III, Cardiology, University Hospital of Heidelberg, Heidelberg, Germany.
Matthias Mueller-HennessenDepartment of Internal Medicine III, Cardiology, University Hospital of Heidelberg, Heidelberg, Germany.
Norbert FreyDepartment of Internal Medicine III, Cardiology, University Hospital of Heidelberg, Heidelberg, Germany.
Hugo KatusDepartment of Internal Medicine III, Cardiology, University Hospital of Heidelberg, Heidelberg, Germany.
Evangelos GiannitsisDepartment of Internal Medicine III, Cardiology, University Hospital of Heidelberg, Heidelberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGuidelines of the European Society of Cardiology recommend a clinical risk assessment for patients with atrial fibrillation (AF). However, scores such as the CHA2DS2-VASc score show only a modest performance for prediction of adverse endpoints.

methodsThis retrospective single-center all-comer study uses data from the Heidelberg Registry of Atrial Fibrillation of 9,995 patients with non-valvular AF presenting to the emergency department (ED) of the University Hospital of Heidelberg from June 2009 until March 2020. Per CHA2DS2-VASc, risk was classified as low (0 point in men, ≤ 1 point in females), intermediate, or high (≥2 points in men and ≥3 points in females). The predictive performance of the CHA2DS2-VASc score, with and without highly sensitive cardiac troponin T (hs-cTnT), was evaluated for a composite endpoint comprising stroke, myocardial infarction (MI) or all-cause mortality.

resultsPerformance of the CHA2DS2-VASc score for the prediction of the composite endpoint was poor Area under the curve (AUC): 0.648 (95%CI: 0.638-0.657) particularly in patients at intermediate-risk AUC: 0.542 (95%CI: 0.508-0.575). Adding hs-cTnT improved discrimination substantially in intermediate-risk patients (AUC: 0.778, 95% CI: 0.748-0.805). Notably, no events occurred in intermediate-risk patients with undetectable hs-cTnT (<5 ng/L).

conclusionIn patients with AF at intermediate thromboembolic risk, the addition of hs-cTnT to the CHA₂DS₂-VASc score enhances prediction of adverse cardiovascular outcomes. Hs-cTnT may help identify patients who could benefit from anticoagulation, while also identifying a low-risk subgroup unlikely to experience events.

Indexed as

Atrial FibrillationTroponin TAgedAged, 80 and overFemaleHumansMaleMiddle AgedMyocardial InfarctionRetrospective StudiesRisk AssessmentRisk FactorsStrokeTroponin T

Identifiers

PMID40839563
PMCPMC12370022

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.