Journal of Diagnostics Concepts & Practice ›› 2024, Vol. 23 ›› Issue (03): 313-317.doi: 10.16150/j.1671-2870.2024.03.009

• Original articles • Previous Articles     Next Articles

Association between NT-proBNP and new-onset atrial fibrillation in patients with ischemic heart failure

LUO Xiaoying, ZHANG Andi(), XU Yan, WU Liqun, QI Wenhang   

  1. Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2024-04-01 Accepted:2024-05-15 Online:2024-06-25 Published:2024-06-25
  • Contact: ZHANG Andi E-mail:xlyouxiangzad@sina.com

Abstract:

Objective To investigate the association between N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and the incidence of new-onset atrial fibrillation (AF) in patients with ischemic heart failure. Methods This study involved 120 patients with ischemic heart failure, characterized by sinus rhythm and a reduced ejection fraction (EF < 40%). NT-proBNP levels were measured at baseline, 6 months, and 12 months. At the 12-month follow-up, patients underwent 12-lead electrocardiography (EKG) or Holter monitoring to identify new-onset AF. Patients were classified into an AF group (n=44) and a non-AF group (n=76). Clinical characteristics and echocardiographic data were reviewed. Receiver operating characteristic (ROC) curves were employed to ascertain the optimal NT-proBNP threshold for predicting new-onset AF, and logistic regression analysis was used to evaluate the prognostic impact of NT-proBNP levels. Results New-onset AF was detected in 36.7% of the cohort. Significant elevations in functional capacity (NYHA class), NT-proBNP levels, E/A ratio, E/E' ratio, pulmonary artery systolic pressure (PASP), pulmonary capillary wedge pressure (PCWP), left atrial volume (LAV), and left atrial volume index (LAVI) were observed in the AF group compared to the non-AF group (P<0.05). NT-proBNP levels demonstrated positive correlations with these echocardiographic parameters (P<0.05). ROC curve analysis identified a baseline NT-proBNP cutoff value of 2357 pg/mL as the most predictive of new-onset AF, with 69% sensitivity and 83% specificity (AUC = 0.825, 95% CI: 0.722-0.924, P<0.001). Logistic regression analysis further established NT-proBNP as the only independent predictive predictor of new-onset AF (OR = 1.24, 95% CI: 1.08-1.43, P=0.001). Conclusions Serum NT-proBNP level is of certain value in prediction of the new-onset AF in patients with ischemic heart failure.

Key words: N-terminal pro-brain natriuretic peptide, Heart failure with low ejection fraction, Ischemic cardiomyopathy, New-onset atrial fibrillation

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