Prognostic Implications Research Articles

An in silico and in vitro approach for understanding CDK2 expression pattern and prognostic implications in breast cancer

An in silico and in vitro approach for understanding CDK2 expression pattern and prognostic implications in breast cancer

Post-TACE ALBI-Score Trajectory in Intermediate and Advanced Hepatocellular Carcinoma: Prognostic Implications and Influencing Factors Analysis.

The long-term effects of transarterial chemoembolization (TACE) on liver function and their prognostic implications in hepatocellular carcinoma (HCC) have not been fully explored. The Albumin-Bilirubin (ALBI) score, an objective measure of liver function, is a validated prognostic tool in HCC. This study aims to characterize the longitudinal trajectories of ALBI-scores after TACE, evaluate their impact on clinical outcomes, and identify factors influencing these trajectories. This retrospective study included patients with BCLC stage B/C HCC who underwent TACE, with baseline and at least two post-TACE ALBI-score measurements. Group-Based Trajectory Modeling (GBTM) was used to identify distinct ALBI-score trajectories. Clinical outcomes and patient characteristics were compared across trajectory groups. A CatBoost-based clinical prediction model was developed to identify factors influencing ALBI-score trajectories, with Shapley Additive Explanations (SHAP) values providing feature importance interpretation. Among 501 patients, three ALBI-score trajectories were identified: improve, stable, and decline. The improve group had better overall survival (OS) and progression-free survival (PFS) compared to the stable and decline groups. Multivariate analysis confirmed that ALBI-score trajectories were independent risk factors for OS. Subgroup analysis suggested that TACE plus systemic therapy reduced mortality risk in the stable and decline groups. The CatBoost model effectively distinguished distinct trajectory groups, with SHAP analysis highlighting ALBI-grade, Child-Pugh class, and tumor number as key predictors. Post-TACE ALBI-score trajectories are closely linked to clinical outcomes, with improved liver function associated with better prognosis. Monitoring these trajectories could guide personalized treatment strategies for HCC patients undergoing TACE.

Prognostic implications and predictive factors of subclinical leaflet thrombosis following valve-in-valve transcatheter aortic valve implantation.

Subclinical leaflet thrombosis, as indicated by hypoattenuated leaflet thickening (HALT) on computed tomography (CT) imaging, remains a major concern owing to its potential impact on valve function and patient outcomes. We aimed to evaluate the association between HALT and clinical outcomes in patients undergoing valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) with balloon-expandable valves and to identify predictors of leaflet thrombosis. Consecutive patients who underwent ViV TAVI with balloon-expandable valves at the Cedars-Sinai Medical Center were retrospectively analysed. We analysed both pre- and postprocedural CT scans to identify predictors of HALT at 1 month after ViV TAVI and the association of HALT with clinical outcomes. The primary outcome was a composite of all-cause mortality, hospitalisation for heart failure (HF), or stroke at 3 years. Among the 117 patients analysed, HALT was detected in 37 (31.6%). In the multivariable analysis, anticoagulation therapy (odds ratio [OR] 0.28, 95% confidence interval [CI]: 0.08-0.92; p=0.037) and greater transcatheter heart valve (THV) expansion at the minimum area level (OR 0.95, 95% CI: 0.91-0.99; p=0.026) were significant predictors of reduced HALT following ViV TAVI. While there was no significant difference in all-cause mortality between patients with and without HALT (OR 1.13, 95% CI: 0.42-3.02; p=0.8), those with HALT had a significantly higher incidence of the composite primary outcome (OR 2.31, 95% CI: 1.04-5.15; p=0.04). HALT was frequently observed in patients who underwent ViV TAVI. Additionally, the presence of HALT correlated with a higher incidence of composite outcomes, including all-cause mortality, hospitalisation for HF, and stroke. Assessment of TRanscathetEr and Surgical Aortic BiOprosthetic VaLVe Dysfunction and Its TrEatment with Anticoagulation (RESOLVE; ClinicalTrials.gov: NCT02318342).

Prospective study of continuous rhythm monitoring in patients with early post-infarction systolic dysfunction: clinical impact of arrhythmias detected by an implantable cardiac monitoring device with real-time transmission-the TeVeO study protocol.

Updated primary prevention strategies are needed for post-infarction sudden cardiac death (SCD) based on implantable cardioverter-defibrillator (ICD). Current recommendations, based on left ventricular systolic function and functional class, may be obsolete because they are derived from ancient studies that do not incorporate the potential benefit of either current comprehensive treatment of ischaemic heart disease or modern device programming. Among patients with post-infarction left ventricular dysfunction, modern implantable cardiac monitoring devices (ICM) allow a unique opportunity to determine in real-time the burden of non-sustained ventricular tachycardias and their relationship to the subsequent occurrence of sustained or symptomatic events. Approximately 200 patients with left ventricular ejection fraction (LVEF) equal to or less than 40% after acute myocardial infarction will be included in the study. They will be implanted with a Confirm RX, an ICM with real-time remote connection via a smartphone. At 6 months, LVEF and functional status will be re-evaluated and cardiac morpho-functional characterisation will be performed by MRI. At this time, and following current European guidelines, patients with an indication will receive an ICD; the others will continue to be monitored using an ICM for a minimum of 2 years. Patients are expected to be followed up for 4 years after the index event. More than 20 000 remote transmissions are expected to be analysed. The study will focus on the relationship between the detection of non-sustained ventricular tachycardias by ICMs (defined as at least 8 R-R intervals at 160 beats per minute) and the subsequent occurrence of symptomatic arrhythmic events. An advanced statistical analysis will be performed using machine and deep learning techniques to determine the clinical variables, those that are derived from monitoring and imaging tests and related to mid-term prognosis. The study was approved by the Ethical Committee of the University Hospital of Salamanca (protocol number PI 2019 03 246) on 30 April 2020. Each patient will be informed about the study in both oral and written form by a physician and will be included in the study after written consent is obtained.For the first time, a study will provide real-time information on the arrhythmic burden of patients with post-infarction ventricular dysfunction and its prognostic implications in the medium term. Several publications in scientific journals are planned. NCT04765943.

SAT-277 Accurate prediction of long-term hepatitis B surface antigen seroclearance with machine learning: prognostic and management implications

SAT-277 Accurate prediction of long-term hepatitis B surface antigen seroclearance with machine learning: prognostic and management implications

Comprehensive characterization of T cell subtypes in lung adenocarcinoma: Prognostic, predictive, and therapeutic implications.

Comprehensive characterization of T cell subtypes in lung adenocarcinoma: Prognostic, predictive, and therapeutic implications.

Parathyroid Involvement by Thyroid Carcinoma: Results from a Single Institution and a Review of the Literature

Background and Objectives: Thyroid cancer (TC) is a common malignancy that accounts for approximately 1% of all human cancers. Given their anatomical proximity to the thyroid, the parathyroid glands (PTGs) are theoretically at risk of tumor involvement. However, PTG metastases are rare and may be underdiagnosed because of routine PTG preservation during thyroidectomy. This study aimed to identify cases of PTG invasion by TC through a 10-year retrospective review at Chosun University Hospital, along with an analysis of the existing literature. Materials and Methods: A total of 1032 thyroidectomy cases were reviewed, and PTG involvement was detected in 10 cases (0.97%). Clinicopathological characteristics were evaluated, and literature data were analyzed. Results: The affected patients included nine females and one male, with a mean age of 46 years (range: 25–77 years). Histological examination confirmed papillary thyroid carcinoma (PTC) in all cases. Tumor invasion into the perithyroid soft tissues was observed in nine patients, and central cervical lymph node metastases were present in four. All patients exhibited PTG Pattern A (direct invasion). Conclusions: Based on our findings and literature data, PTG involvement by TC has an incidence rate of 0.05–3.9%, predominantly affects women in their sixth to seventh decade of life, and appears to have no impact on prognosis unless accompanied by extensive extrathyroidal invasion. Further studies are necessary to determine whether PTG invasion should be integrated into the TNM staging system and to assess its prognostic and therapeutic implications.

Prognostic Implications of Volume-Based Quantitative Biomarkers Derived From 18F-FDG-PET/CT in Pulmonary Sarcoidosis

Prognostic Implications of Volume-Based Quantitative Biomarkers Derived From 18F-FDG-PET/CT in Pulmonary Sarcoidosis

Prognostic Implications of Angiographically Derived Coronary Radial Wall Strain in Diabetic Patients andNon-Flow-Limiting Stenosis.

Prognostic Implications of Angiographically Derived Coronary Radial Wall Strain in Diabetic Patients andNon-Flow-Limiting Stenosis.

Multi‑omics analysis identifies different molecular subtypes with unique outcomes in early-stage poorly differentiated lung adenocarcinoma

IntroductionEarly-stage poorly differentiated lung adenocarcinoma (LUAD) is plagued by a high risk of postoperative recurrence, and its prognostic heterogeneity complicates treatment and surveillance planning. We conducted this integrative multi-omics study to identify those patients with a truly high risk of adverse outcomes.MethodsWhole-exome, RNA and whole methylome sequencing were carried out on 101 treatment-naïve early-stage poorly differentiated LUADs. Integrated analyses were conducted to disclose molecular characteristics and explore molecular subtyping. Functional validation of key molecules was carried out through in vitro and in vivo experiments.ResultsRecurrent tumors exhibited significantly higher ploidy (p = 0.024), the fraction of the genome altered (FGA, p = 0.042), and aneuploidy (p < 0.05) compared to non-recurrent tumors, as well as a higher frequency of CNVs. Additionally, recurrent tumors showed hypomethylation at both the global level and in CpG island regions. Integrative transcriptomic and methylation analyses identified three molecular subtypes (C1, C2, and C3), with the C1 subtype presenting the worst prognosis (p = 0.024). Although frequently mutated genes showed similar mutation frequencies across the three subtypes, the C1 subtype exhibited the highest tumor mutation burden (TMB), mutant-allele tumor heterogeneity (MATH), aneuploidy, and HLA loss of heterozygosity (HLA-LOH), along with relatively lower immune cell infiltration. Furthermore, GINS1 and CPT1C were found to promote LUAD progression, and their high expression correlated with a poor prognosis.ConclusionsThis multi-omics study identified three integrative subtypes with distinct prognostic implications, paving the way for more precise management and postoperative monitoring of early-stage poorly differentiated LUAD.

Prognostic Significance of Time Between Balloon and Peak CK-MB in AMI Patients Undergoing Primary PCI.

Prognostic Significance of Time Between Balloon and Peak CK-MB in AMI Patients Undergoing Primary PCI.

Coronary computed tomography in the clinical arena. Recent evidence and future perspectives

In the past few years, computed tomography coronary angiography (CTCA) has rapidly become a widely used diagnostic tool in several clinical settings and is recommended by the European guidelines with a high degree of recommendation in patients with suspected coronary artery disease. The rapid accumulation of evidence is tumultuous and clinical use has grown in parallel with the possibility of offering significant advantages in many areas. Today, CTCA is used both in the diagnosis of low-risk chest pain in emergency departments and in the recognition and prognostic assessment of stable coronary artery disease. By identifying the presence, extent, and quality of atherosclerotic disease, CTCA today offers an important tool for the identification of the disease, promoting the best therapeutic choices with significant prognostic implications, a high safety profile and potentially significant savings in resources. New applications and evidence are accumulating thanks to the marriage of CTCA with artificial intelligence. Alongside increasing accuracy, new risk markers have been identified that enrich the informative content of this method. This review reports the most significant studies that have marked this path so far.

Risk Factors and Prognostic Implications of Tumor-Related Epilepsy in Diffuse Glioma Patients: A Real-World Multicenter Study.

The relevance of tumor-related epilepsy (TRE) to glioma survival is controversial. This study aimed to assess the risk factors and prognostic impact of TRE in adult patients with diffuse gliomas by integrating clinical, radiological, and molecular data. This multicenter retrospective study included 1036 adult patients with diffuse gliomas from local hospitals and the POLA Network. Patients were categorized into three prognostic groups: lower-grade oligodendroglioma/astrocytoma (OD/AC, II-III, IDH-MT), not otherwise specified or not elsewhere classified (NOS/NEC, II-III, IDH-WT), and high-grade gliomas (HGG, IV). Clinico-radiological, molecular, and therapeutic factors were analyzed using univariate and multivariate logistic regression, with the Cox proportional hazards model applied to identify independent prognostic factors for progression-free survival (PFS) and overall survival (OS). TRE occurred in 44.4% of OD/AC patients, 25.8% of NOS/NEC patients, and 16.5% of HGG patients. Multivariate analysis identified age as the only significant independent correlate of TRE in the OD/AC group (OR = 0.961; p = 0.004), while the absence of deep structure involvement was independently associated with TRE in the NOS/NEC and HGG groups. In univariate analysis, the presence of TRE was associated with longer PFS and OS across all groups, particularly in the NOS/NEC group, where patients with TRE had a median PFS of 35.2 months compared to 13.6 months in those without TRE (p = 0.02), but was not a significant predictor in multivariate analyses. TRE was the only factor significantly associated with maintaining histological grade at recurrence (HR = 0.094; p = 0.005). TRE was not a strong independent prognostic factor after controlling for clinical and molecular tumor features, suggesting that the prognostic relevance of TRE is likely driven by underlying glioma biology and other associated clinical factors.

Prognostic implications of the left atrial stiffness index in patients with cardiac amyloidosis.

Prognostic implications of the left atrial stiffness index in patients with cardiac amyloidosis.

Prognostic Implications of HPV Cell-Free DNA Serial Testing During Follow-Up of p16 Positive Oropharyngeal Squamous Cell Carcinoma After Curative-Intent Treatment.

Plasma circulating HPV cell-free DNA has high sensitivity and specificity for the detection of HPV-mediated oropharyngeal squamous cell carcinoma. We investigated the clinical significance of serial testing after curative-intent treatments. Patients with concordant p16 positive tumour or neck node biopsy and positive high-risk HPV plasma cell-free DNA were prospectively recruited. HPV cell-free DNA were obtained using digital droplet polymerase chain reaction (ddPCR) and were collected at diagnosis and at every clinical follow-up. Three months after completion of curative-intent treatments, patients were stratified according to treatment response on computed tomography. Complete responders (CR) were followed-up clinically, partial responders (PR) underwent further imaging and surgical/medical management if appropriate, patients with progressive disease (PD) received palliative treatments. A hundred and fourteen patients were included and 717 HPV cfDNA ddPCR samples were analysed during a median follow-up of 103 weeks (IQR, 40.2-147.8). Ninety (78.9%) patients were classified as CR, 18 (15.8%) as PR and all except one, who was rapidly diagnosed with PD, had negative HPV ddPCR at 12 weeks follow-up; 6 (5.3%) had PD and all except one had positive HPV ddPCR. Eleven had recurrent disease, 6 in the CR group (6.6%) and 5 among PR (27.7%). Ninety patients had consistently negative HPV ddPCR at all time points and one developed a recurrence (NPV 99%, 95% C.I., 93.2-99.8%). Eighteen patients developed positive HPV ddPCR and 10 developed recurrent disease (PPV 55%, 95% C.I., 38.6-71.4%). Ten patients had two consecutively positive HPV ddPCR and all had proven disease (PPV 100%, 95% C.I., 69.2-100%). Nine patients had transiently positive HPV ddPCR and none developed disease at that time. Post-treatment HPV ddPCR reflected treatment response on imaging and serial testing had high PPV and NPV in detecting recurrent disease.

Augmented renal clearance in neurosurgical patients receiving vancomycin: Limited prognostic value for the duration of hospitalization, treatment course, fever, and changes in the CSF test and CRP.

In patients with augmented renal clearance (ARC) receiving vancomycin, therapeutic drug monitoring (TDM) is recommended in accordance with the 2020 guidelines. This study was conducted to delineate the profile of ARC and TDM in non-critically ill, non-trauma, non-stroke neurosurgical patients receiving vancomycin, thereby elucidating the additional risk factors and prognostic implications of ARC. A single-center retrospective review of clinical data was performed from patients who were consecutively admitted to the Neurosurgical Department of Beijing Tongren Hospital, Capital Medical University, Beijing, China, from November 1, 2017, to October 31, 2022, and received vancomycin. 62 patients with a maximum ICU stay of 72 hours were included. ARC was defined as an estimated glomerular filtration rate (eGFR) of > 130 mL/min/1.73m2 in the main analysis. A difference analysis based on ARC risk factors, correlation analysis, and multiple linear regression was conducted. The eGFR of the total patient cohort was 115.41 ± 13.39 mL/min/1.73m2 (mean ± SD), whereas 10 patients (16.13%) had eGFRs > 130 mL/min/1.73m2. Younger ages and mannitol co-administration were risk factors for ARC, whereas increased eGFR was not associated with prognostic implications for hospital stay, treatment course, fever duration, or duration to normalization of the CSF test or CRP level. A minimum of 16.13% of non-critical, non-trauma, non-stroke neurosurgical patients exhibit ARC. ARC was not associated with anti-infection prognosis. This finding suggests that further evaluation of ARC-guided TDM of these populations is warranted.

Dual Role of CRABP2 in Colorectal Cancer: Oncogenesis via Nuclear RB1 and Cytoplasmic AFG3L2/SLC25A39 Axis, While Limiting Liver Metastasis through Cytoplasmic AFG3L2/PINK1/Parkin-Mediated Mitophagy.

Colorectal cancer (CRC) progression and metastasis involve numerous regulatory factors. Among these, cellular retinoic acid-binding protein 2 (CRABP2) has been implicated as both a tumor activator and suppressor. Here, it is aimed to clarify the role of CRABP2 in CRC growth and metastasis and explore the underlying molecular mechanisms mediating its cellular functions. Using both in vitro and in vivo models, including a colonocyte-specific CRABP2 conditional knockout mouse model (Crabp2ΔIEC) and a subcutaneous tumorigenesis assay in BALB/c nude mice, it is shown that nuclear CRABP2 enhances tumor growth by interacting with and downregulating the tumor suppressor RB1, whereas cytoplasmic CRABP2 suppresses CRC liver metastasis by interacting with AFG3L2 and promoting mitophagy. In addition, the AFG3L2-SLC25A39 axis is identified as a distinct mechanism by which cytoplasmic CRABP2 increases mitochondrial glutathione stability to promote cell proliferation independent of the nuclear RB1 pathway. Notably, analysis of tissue from CRC patients reveals that CRABP2 protein has distinct prognostic implications and functional roles in the progression and metastasis of CRC dependent on its subcellular localization. Ultimately, by elucidating the role of CRABP2 in CRC, it is aimed to provide new insight into disease pathogenesis and inform the development of therapeutic interventions.

Prognosis of Robot-Assisted Esophagectomy with Thoracic Duct Resection in Esophageal Squamous Cell Carcinoma.

The authors' previous study found no significant difference in short-term clinical outcomes between patients undergoing robot-assisted esophagectomy (RAE) with or without thoracic duct resection (TDR). However, the impact of RAE-TDR on long-term prognosis remains unclear. From January 2019 to July 2020, the study prospectively and consecutively enrolled 127 thoracic duct (TD)-preserved and 73 TD-resected patients who underwent standard McKeown RAE surgery. The overall survival (OS) and recurrence-free survival (RFS) were compared between these two groups. During a median follow-up period of 48.6months, the 3-year OS rates were70.6% and 70.9% in the TD-preserved and TD-resected group, andthe 3-year RFS rates were 61.9% and 55.5%, respectively. The TD-preserved and TD-resected groups did not differ significantly in local-regional (12.6% vs. 15.1%; p = 0.623), distant (23.6% vs. 28.8%; p = 0.422), or mixed (2.4% vs. 4.1%; p = 0.670) recurrence. However, among the eight (11%) patients with TD lymph node (LN) metastasis in the TD-resected group, six patients experienced recurrences (1 local-regional and 5 distant). The patients who had thoracic duct lymph node (TDLN) metastasis experienced significantly worse RFS than those who did not (p = 0.04). Additionally, TDLN metastasis was significantly associated with advanced nodal stage (cN2-3, 6/8; p = 0.001) and bulky tumors (pT3, 7/8; p = 0.028). In ESCC, RAE-TDR does not improve recurrence or survival outcomes. However, identification of TDLN metastasis through TDR carries significant prognostic implications considering its strong association with aggressive tumor biology and inferior oncologic outcomes. Therefore, TDR should not be routinely performed, but its selective application for patients with advanced tumors may provide critical staging information to guide tailored postoperative strategies.

Single-cell sequencing unveils the transcriptomic landscape of castration-resistant prostate cancer-associated fibroblasts and their association with prognosis and immunotherapy response

BackgroundThe tumor microenvironment (TME) is increasingly acknowledged as a determinant in the malignant transformation and progression of castration-resistant prostate cancer (CRPC). Cancer-associated fibroblasts (CAFs), as a pivotal stromal cellular component in TME, are implicated in tumor progression and immune escape. However, the molecular characteristics and biological functions of CRPC-CAFs in prostate cancer necessitate further investigation.MethodsWe ascertained the differential transcriptomic profiles between CRPC-CAFs and PCa-CAFs through single-cell RNA-sequencing (scRNA-seq). Bulk RNA-seq data were employed to assess the prognostic implications of CRPC-CAFs in PCa. In addition, we examined the impact of CRPC-CAFs on the efficacy of immunotherapy and the composition of the tumor immune milieu. Furthermore, a subcutaneous PCa model was applied to determine the potential of TGF-β signaling blockade to augment the response to immunotherapeutic interventions.ResultsWe observed a pronounced increase in the proportion of CAFs in CRPC compared to those in primary PCa. The functional pathways implicated in TGF-β signaling and ECM remodeling were remarkably upregulated in CRPC-CAFs. Moreover, gene regulatory network analysis uncovered substantial differences in the transcription factor activity profiles between CRPC-CAFs and PCa-CAFs. The elevated CRPC-CAFs abundance was associated with diminished recurrence-free survival and immunotherapy insensitivity. Substantially elevated infiltration of inhibitory immune cells and upregulated expression levels of immunosuppressive molecules were observed in patients with high CRPC-CAFs abundance. Importantly, administration of anti-TGF-β therapy remarkably potentiated the efficacy of anti-PD-1 immunotherapy through upregulating the anti-tumor immune response in the PCa model.ConclusionOur results highlighted the impact of CRPC-CAFs on clinical prognosis and immunosuppressive tumor milieu, indicating that CRPC-CAFs may function as a promising therapeutic target for CRPC.

Cardiomyopathy-Associated Gene Variants in Atrial Fibrillation

Patients with atrial fibrillation (AF), a common morbid arrhythmia, are more likely to carry rare genetic variants associated with inherited cardiomyopathies. Prior studies on rare pathogenic variants in AF relied on small, hospital referral populations, and knowledge on clinical outcomes remains limited. To evaluate the prevalence and prognostic implications of cardiomyopathy-associated pathogenic or likely pathogenic (CMP-PLP) genetic variants in patients with AF. In 2 prospective cohort studies, the prevalence of CMP-PLP variants was assessed in the population of patients with AF and early-onset AF. The association between carrying a CMP-PLP variant and the risk of incident cardiomyopathy or heart failure (CMP/HF) after AF diagnosis was evaluated. Finally, the joint contributions of CMP-PLP variants, clinical risk, and polygenic risk were assessed. Included in this study were 2 large longitudinal cohort studies, the UK Biobank (UKB) (data 2006-2023) and the All of Us Research Program (AllofUs) (2018-2022). The UKB and AllofUs cohorts, respectively, contained 393 768 and 193 232 unrelated genotyped participants. CMP-PLP variants. Prevalence of CMP-PLP variants and risk of incident CMP/HF after AF diagnosis. In the UKB cohort, 32 281 participants (8%) had AF (mean [SD] age, 62 [6] years; 20 459 male [63.4%]). In the AllofUs cohort, 11 901 participants (6%) had AF (mean [SD] age, 67 [12] years; 6576 male [55.3%]). Compared with the biobank populations, CMP-PLP variants were twice as prevalent in patients with AF (UKB, 2.04%; 95% CI, 1.89%-2.20%; AllofUs, 2.52%; 95% CI, 2.25%-2.82%) and 5 times as prevalent in AF with onset before age 45 years (UKB, 4.99%; 95% CI, 3.07%-7.91%; AllofUs, 4.66%; 3.40%-6.32%). Cumulative incidence of CMP/HF was high in patients with AF (18%) compared with patients without AF (3%). Still, among patients with AF without prior CMP/HF (UKB, 20 226; AllofUs, 8330), carrying a CMP-PLP variant was associated with 1.6-fold risk of incident CMP/HF (meta-analysis, 95% CI, 1.32-1.90). Finally, CMP-PLP variants, a polygenic score, and clinical risk factors were independent estimators of CMP/HF. Results of this cohort study suggest that the prevalence of CMP-PLP variants was substantial in patients with early-onset AF. Patients with AF carrying a CMP-PLP variant had an associated increased risk of future CMP/HF, independent of clinical and polygenic risk. These results indicate that genetic testing in patients with AF may identify individuals at higher risk for developing CMP/HF.