Patients with acute cerebral ischemia and NT-proBNP levels above the median (239 pg/ml) had a significantly higher rate of paroxysmal atrial fibrillation compared to those below the median (17.9% vs 7.4%).
Observational (n=281)
Blinded to clinical data
No
Does elevated BNP or NT-proBNP predict the presence of paroxysmal atrial fibrillation in patients with acute cerebral ischemia?
BNP is an independent predictor of paroxysmal atrial fibrillation in patients with acute cerebral ischemia and can be used to effectively select patients for prolonged Holter monitoring.
Absolute Event Rate: 17.9% vs 7.4%
p-value: p=0.025
BACKGROUND AND PURPOSE: Diagnosis of paroxysmal atrial fibrillation (AF) can be challenging, but it is highly relevant in patients presenting with sinus rhythm and acute cerebral ischemia. We aimed to evaluate prospectively whether natriuretic peptide levels and kinetics identify patients with paroxysmal AF. METHODS: Patients with acute cerebral ischemia were included into the prospective observational Find-AF study. N-terminal pro brain-type natriuretic peptide (NT-proBNP), brain-type natriuretic peptide (BNP) and N-terminal pro atrial-type natriuretic peptide (NT-proANP) plasma levels were measured on admission, after 6 and 24 hours. Patients free from AF at presentation received 7 day Holter monitoring. We prospectively hypothesized that patients presenting in sinus rhythm with NT-proBNP>median were more likely to have paroxysmal AF than patients with NT-proBNPmedian (239 pg/ml), 17.9% had paroxysmal AF in contrast to 7.4% with NT-proBNP<239 pg/ml (p = 0.025). The ratio of early (0 h) to late (24 h) plasma levels of NT-proBNP showed no difference between both groups. For the detection of paroxysmal atrial fibrillation, BNP, NT-proBNP and NT-proANP at admission had an area under the curve in ROC analysis of 0.747 (0.663-0.831), 0.638 (0.531-0.744) and 0.663 (0.566-0.761), respectively. In multivariate analysis, BNP was the only biomarker to be independently predictive for paroxysmal atrial fibrillation. CONCLUSIONS: BNP is independently predictive of paroxysmal AF detected by prolonged ECG monitoring in patients with cerebral ischemia and may be used to effectively select patients for prolonged Holter monitoring.
Wachter et al. (Wed,) conducted a observational in Acute cerebral ischemia (n=281). NT-proBNP > median (239 pg/ml) vs. NT-proBNP < median (239 pg/ml) was evaluated on Detection of paroxysmal atrial fibrillation on 7-day Holter monitoring (p=0.025). Patients with acute cerebral ischemia and NT-proBNP levels above the median (239 pg/ml) had a significantly higher rate of paroxysmal atrial fibrillation compared to those below the median (17.9% vs 7.4%).