The ABC stroke, bleeding and mortality risk scores

Development and Research over time

Professor Lars Wallentin, Cardiologist and researcher at the Swedish Uppsala Clinical Research Center is involved in multiple precision medicine research projects concerning biomarkers. Today he shares a comprehensive summary of key findings from his research into the ABC (Age, Biomarkers, Clinical Information) scores over the last decade.

Based on the value of NT-proBNP, Troponin and GDF-15 as markers of cardiac dysfunction, myocardial damage and oxidative stress (biological aging) respectively; a combination of biomarkers and clinical factors were found to better prognosticate stroke and bleeding risk in Atrial Fibrillation (AF) patients compared to using only clinical risk factors.

Further research was conducted in the ARISTOTLE trial and the RE-LY trial, and the ABC scores were developed for stroke, bleeding and death. In the ABC scores ‘biomarkers’ are the most important component and were developed based on patients on anticoagulants. 

With the stroke rate in untreated patients being three times higher, the ABC scores needed further testing in patients not taking anticoagulants. Through collaboration with investigators of the ACTIVE A trial and the AVERROES trials, the ABC scores were recalibrated to provide precise risk stratification for patients without anticoagulant treatment.

The ABC scores are continuous, well calibrated and provide better discrimination than current standard of care. To help increase the use of biomarkers in AF patients, an educational approach including additional aid from professional societies is needed. Consequently, ABC scores can be implemented for risk stratification of bleeding and stroke in AF patients.

Key facts
  • Listen to Prof. Lars Wallentin as he shares key findings from the last decade of research in ABC (Age, Biomarkers and Clinical Information) scores.
  • His latest research is based on the value of NT-proBNP, Troponin and GDF-15 and the finding that a combination of biomarkers and clinical factors can more precisely prognosticate risk in Atrial Fibrillation (AF) patients.
  • Learn more about ABC scores as a continuous, well-calibrated solution that provides better discrimination between stroke and bleeding risk in AF patients.
  • In the future, implementing biomarkers in AF will spearhead uptake of ABC scores and better risk stratification for AF patients.