Key result
Elevated baseline BNP is linked to higher 1-year thromboembolic and atherosclerotic event rates.
Why the study?
The relationship between brain natriuretic peptide (BNP) and thromboembolic events in elderly patients with nonvalvular atrial fibrillation (NVAF) was not fully characterized.
Does an elevated baseline brain natriuretic peptide (BNP) level predict a higher risk of thromboembolic and atherosclerotic events in elderly patients with nonvalvular atrial fibrillation?
Cohort (n=180)
No
Does an elevated baseline brain natriuretic peptide (BNP) level predict a higher risk of thromboembolic and atherosclerotic events in elderly patients with nonvalvular atrial fibrillation?
Elevated admission BNP levels are independently associated with higher 1-year rates of thromboembolic, atherosclerotic, and heart failure adverse events in elderly NVAF patients post-ablation, supporting BNP as a prognostic biomarker for risk stratification.
May support BNP for risk stratification in elderly NVAF; hypothesis-generating and requires prospective validation before practice change.
Objective. To investigate the relationship between brain natriuretic peptide (BNP) and thromboembolic events in elderly patients with nonvalvular atrial fibrillation (NVAF). Methods. This is a prospective cohort study, and based on the inclusion and exclusion criteria, 180 elderly patients with NVAF were included. The patients received follow-up appointments in the clinic or by telephone every 6 months after the beginning of the study. The primary follow-up endpoints were thromboembolic and atherosclerotic events, including ischaemic stroke, myocardial infarction, and systemic embolism. The secondary endpoints were adverse events, including cardiovascular death, all-cause death, and hospitalisation for heart failure. Patients were divided into three groups according to their BNP level at admission: group A (BNP ≤334.5 pg/mL), group B (BNP = 334.5–1,288 pg/mL), and group C (BNP ≥1,288 pg/mL). Results. A total of 180 patients were enrolled in this study, with 50 patients in group A, 68 in group B, and 62 in group C. Compared with groups A and B, group C had a higher CHA2DS2-VASc score (Z = 15.142; P=0.001 ) and a lower ejection fraction (EF) value (Z = 119.893; P=0.001 ). The left atrium (LA) and left ventricular end-diastolic diameter (LVEDD) were larger (Z = 105.031; P=0.001 and Z = 74.430; P=0.001 ), respectively, suggesting that patients with significantly increased BNP had a higher risk of thromboembolism and atherosclerosis, lower EF, larger LA and LVEDD, and worse cardiac function. After 1 year of follow-up, the incidence of primary endpoint events (χ2 = 9.556; P=0.008 ) and secondary endpoint events (χ2 = 59.485; P=0.001 ) in group C were higher than those in groups A and B. Conclusion. Higher BNP levels may be an independent risk factor for thromboembolic and atherosclerotic events in elderly patients with NVAF. The higher the BNP level, the greater the risk of thromboembolic and atherosclerotic events.
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Wang et al. (2024) conducted a cohort in Nonvalvular atrial fibrillation (NVAF) (n=180). Elevated baseline Brain Natriuretic Peptide (BNP >=1,288 pg/mL) vs. Low/normal baseline BNP (<=334.5 pg/mL) and slightly elevated baseline BNP (334.5-1,288 pg/mL) was evaluated on Composite of thromboembolic and atherosclerotic events (ischaemic stroke, myocardial infarction, and systemic embolism) at 1 year (OR 1.001, p=0.008). Significantly elevated baseline BNP (>=1,288 pg/mL) was associated with a higher 1-year incidence of thromboembolic and atherosclerotic events compared to normal BNP (26.2% vs 6.0%, P=0.008; OR 1.001).
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