Back to Search Start Over

NT‐proBNP as a marker for atrial fibrillation and heart failure in four observational outpatient trials

Authors :
Stephan B. Felix
Lutz Binder
Kathleen Nolte
Christoph Herrmann-Lingen
Rolf Wachter
Ulrich Laufs
Helge Haarmann
Stefan Gross
Frank T. Edelmann
Gerd Hasenfuß
Christian Becker
Marcus Dörr
Daniela Husser
Meinhard Mende
Martin Scherer
Stefanie Maria Werhahn
Samira Zeynalova
Astrid Petersmann
Nikolaos Dagres
Markus W. Löffler
Burkert Pieske
Source :
ESC Heart Failure, ESC Heart Failure, Vol 9, Iss 1, Pp 100-109 (2022)
Publication Year :
2021
Publisher :
John Wiley and Sons Inc., 2021.

Abstract

Aims Heart failure (HF) and atrial fibrillation (AF) frequently coexist and are both associated with increased levels of N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP). It is known that AF impairs the diagnostic accuracy of NT‐proBNP for HF. The aim of the present study was to compare the diagnostic and predictive accuracy of NT‐proBNP for HF and AF in stable outpatients with cardiovascular risk factors. Methods and results Data were obtained from the DIAST‐CHF trial, a prospective cohort study that recruited individuals with cardiovascular risk factors and followed them up for 12 years. Data were validated in three independent population‐based cohorts using the same inclusion/exclusion criteria: LIFE‐Adult (n = 2869), SHIP (n = 2013), and SHIP‐TREND (n = 2408). Serum levels of NT‐proBNP were taken once at baseline. The DIAST‐CHF study enrolled 1727 study participants (47.7% female, mean age 66.9 ± 8.1 years). At baseline, patients without AF or HF (n = 1375) had a median NT‐proBNP of 94 pg/mL (interquartile range 51;181). In patients with AF (n = 93), NT‐proBNP amounted to 667 (215;1130) pg/mL. It was significantly higher than in the first group (P 50% [n = 38; 603 (175;1070) pg/mL] and those without HF (P = 1.0). Receiver‐operating characteristic curves of NT‐proBNP showed a similar area under the curve (AUC) for the detection of AF at baseline (0.84, 95% CI [0.79–0.88]) and for HF with EF 50% was significantly lower (0.61 [0.56–0.65]) than for AF (P = 0.001). During follow‐up, AF was newly diagnosed in 157 (9.1%) and HF in 141 (9.6%) study participants. NT‐proBNP was a better predictor of incident AF during the first 2 years (AUC: 0.79 [0.75–0.83]) than of newly diagnosed HF (0.59 [0.55–0.63]; P 50% is very limited.

Details

Language :
English
ISSN :
20555822
Volume :
9
Issue :
1
Database :
OpenAIRE
Journal :
ESC Heart Failure
Accession number :
edsair.doi.dedup.....7705e2e3176ce234b0cee9bf6b39d60b