NT-proBNP ‘major predictor’ of AF
MedWire News: N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a “remarkable” predictor of incident atrial fibrillation (AF), say researchers.
Their study of 5445 Cardiovascular Health Study participants demonstrated a robust relationship between NT-proBNP levels and both the prevalence and incidence of AF.
As reported in an advance online publication by the journal Circulation, NT-proBNP level was strongly associated with a diagnosis of AF at enrolment, with an adjusted prevalence ratio of 147 for the highest versus lowest quintile of NT-proBNP (p<0.001).
Meanwhile, analysis of incident AF revealed a linear risk gradient, with the risk for AF growing significantly with each increasing quintile of NT-proBNP.
The estimated cumulative incidence of AF over 16 years was 64% in the highest NT-proBNP quintile versus 20% in the lowest. And Cox proportional hazards analysis showed baseline NT-proBNP level was a “considerably stronger” predictor of AF development than any other clinical covariate, reports the team.
Hazard ratios for AF after adjustment for an extensive number of covariates were 1.4, 1.8, 2.4, and 4.0 across the second to fifth (highest) quintiles, respectively, relative to the lowest quintile.
“These findings suggest that NT-proBNP might be useful in identifying patients at risk for AF many years before its occurrence,” say Richard Kronmal (University of Washington, Seattle, USA) and team.
They conclude: “In the future, this simple test might allow an early initiation of therapies designed to prevent the development of AF. In addition, these findings offer insight into the pathophysiology of underlying AF.”
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By Caroline Price