Study Finds No Advantage of Biomarker-Based Risk Scores in Personalizing Atrial Fibrillation Treatment

Recent research presented at ESC Congress 2025 has concluded that using biomarker-based risk scores to tailor treatment strategies in patients with atrial fibrillation (AF) does not lead to improved clinical outcomes compared to standard guideline-based care. The study, a large registry-based randomized trial conducted across 39 Swedish sites, investigated whether incorporating biomarker scores like ABC-AF-stroke and ABC-AF-bleeding into treatment decisions would reduce the incidence of stroke and death.

Patients eligible for the trial included adults diagnosed with AF, regardless of whether they were on oral anticoagulant (OAC) therapy. Participants were randomized into two groups: a treatment arm guided by individual risk scores and recommendations, and a control group managed under usual clinical practice without biomarker data. Although the intervention successfully increased OAC use broadly, the primary outcome—composite of stroke or death—occurred at similar rates in both groups, around 3.2/100 patient-years.

The trial also found no significant differences in the rates of stroke, death, or major bleeding between the two arms over a median follow-up of 2.6 years. Despite the promising validation of these biomarker scores in previous studies, the results suggest that their implementation for personalized treatment did not provide additional benefit in this population. Notably, the trial was prematurely terminated due to safety concerns, and the event rates were lower than expected, leading to an underpowered study.

Lead researcher Professor Jonas Oldgren emphasized that further prospective testing is essential before integrating new risk stratification tools into routine AF management. Overall, this study underscores the importance of rigorous validation of precision medicine approaches and suggests that current standard care remains effective for stroke prevention in AF patients.

Source: https://medicalxpress.com/news/2025-09-benefit-biomarker-based-scores-personalize.html