Key result
Elevated NT-proBNP accurately identifies persistent AF vs. healthy controls with ~1.00 AUC.
Why the study?
Differences in biomarkers implicated in atrial anatomical and electrophysiological changes between patients with AF and healthy controls were not well characterized.
Do biomarkers such as NT-proBNP, ST2, and Hs-Tn T differ significantly between patients with persistent non-valvular atrial fibrillation and healthy controls?
Cross-Sectional (n=148)
No
Do biomarkers such as NT-proBNP, ST2, and Hs-Tn T differ significantly between patients with persistent non-valvular atrial fibrillation and healthy controls?
Absolute Event Rate: 1054.2% vs 58.31%
p-value: p=<0.001
Biomarkers of myocardial stretch and injury, particularly NT-proBNP, are significantly elevated in patients with persistent non-valvular atrial fibrillation compared to healthy controls, suggesting a role in the onset of the arrhythmia.
Atrial fibrillation (AF) is explained by anatomical and electrophysiological changes in the atria determined by high pressure, dilatation, infiltration and inflammation in the myocardium. There are some biomarkers implicated in these processes, namely, NT-proBNP, high sensitivity troponin (Hs-Tn), urate, galectin-3, ST2, C reactive protein and fibrinogen. The aim of this study was to assess differences in these biomarkers between patients with AF and healthy controls. We designed a cross-sectional study consecutively including all patients undergoing electrical cardioversion in our hospital for persistent AF and matched healthy controls. We included 115 patients with persistent non-valvular AF and 33 healthy subjects. The biomarkers NT-proBNP, ST2 and Hs-Tn T were significantly related to the presence of AF (1054 ± 833.30 vs. 58.31 ± 59.40, p < 0.001; 35.43 ± 15.89 vs. 27.43 ± 10.95, p < 0.001 and 10.25 ± 6.11 vs. 8.42 ± 6.85, p < 0.001, respectively). NT-proBNP was the best biomarker differentiating AF patients (area under the curve 0.995). The best NT-proBNP cut-off point to differentiate AF was 102 pg/mL; for Hs-Tn T it was 11.5 ng/L and for ST2 it was 37.7 ng/mL. It is possible that these biomarkers intervene at the onset of AF and have no role in AF maintenance.
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Merino‐Merino et al. (2022) conducted a cross-sectional in Atrial Fibrillation (n=148). Persistent non-valvular atrial fibrillation vs. Healthy controls was evaluated on NT-proBNP levels (pg/mL) (p=<0.001). NT-proBNP levels were significantly higher in patients with persistent atrial fibrillation compared to healthy controls (1054.20 vs 58.31 pg/mL, p<0.001), demonstrating excellent diagnostic accuracy (AUC 0.995).
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