Higher logNT-proBNP levels were associated with a significantly increased risk of cardioversion failure (OR 4.80; 95% CI 1.58–14.55; p=0.006) and AF recurrence or persistence at day 8.
Observational (n=148)
Does NT-proBNP predict cardioversion failure and short-term AF recurrence in patients with recent-onset atrial fibrillation?
NT-proBNP levels prior to cardioversion can predict the likelihood of cardioversion failure and short-term AF recurrence in emergency department patients with recent-onset AF.
Estimación del efecto: OR 4.80 (95% CI 1.58-14.55)
valor p: p=0.006
Background: Atrial fibrillation (AF) is a common arrhythmia in the emergency department (ED). We investigated the role of N-terminal pro b-type natriuretic peptide (NT-proBNP) in predicting both the outcome of AF cardioversion and the risk of AF recurrence or persistence on the 8th (D8) and 30th (D30) day post-cardioversion. Methods: This prospective, observational study evaluated patients with recent-onset AF, managed by either pharmacological (PC) or electrical cardioversion (EC) in the ED. Patients were treated either immediately or electively after 3 weeks of anticoagulation. NT-proBNP assessments were performed prior to cardioversion. Results: Of the 148 patients enrolled, 56% had paroxysmal AF, 85% underwent immediate cardioversion and 72% received EC. Successful cardioversion to sinus rhythm (SR) was achieved in 85% of patients. Patients with successful cardioversion and those who remained free from AF on D8 had lower NT-proBNP levels compared to patients with failed cardioversion or with AF recurrence or persistence on D8 day of cardioversion, D0: SR vs. non-SR, 387 (127–1095) pg/mL vs. 1262 (595–2295), p = 0.004; D8: SR vs. non-SR, 370 (127–1095) vs. 1366 (718–2295), p = 0.002. In multivariate analysis, higher logNT-proBNP was associated with higher risk of cardioversion failure OR, 95%CI: 4.80 (1.58–14.55), p = 0.006 and AF recurrence or persistence on D8 OR, 95%CI: 3.65 (1.06–12.59), p = 0.041. ROC analysis confirmed the predictive ability of NT-proBNP for both outcomes (D0: AUC 0.735, p 580 pg/mL was able to predict failure of AF conversion and occurrence of recurrent/persistent AF at D8. Conclusions: NT-proBNP is a promising biomarker for identifying patients presenting to the ED with recent-onset AF who run a greater risk of cardioversion failure and post-discharge AF recurrence/persistence in the immediate and short term.
Diakantonis et al. (Thu,) conducted a observational in Recent-onset atrial fibrillation (n=148). NT-proBNP assessment was evaluated on Cardioversion failure (OR 4.80, 95% CI 1.58-14.55, p=0.006). Higher logNT-proBNP levels were associated with a significantly increased risk of cardioversion failure (OR 4.80; 95% CI 1.58–14.55; p=0.006) and AF recurrence or persistence at day 8.