Association Between Brain Natriuretic Peptide Level and Atrial Fibrillation: A Systematic Review and Meta-Analysis

Background and objectivesPrevious studies suggest a link between brain natriuretic peptide (BNP) levels and atrial fibrillation (AF). However, the nature of this relationship is disputed. To address this, we conducted a study to gather and assess evidence on the association between BNP and AF.MethodologyStudies were systematically searched and collected from four databases and different types of gray literature. After the screening, the selected articles' quality and risk of bias assessment were evaluated. Meta-analysis calculated std. Mean difference on the extracted data. Furthermore, heterogeneity, sensitivity, subgroups, and publication bias analyses were assessed.ResultsSixteen studies were included in this systematic review. The meta-analysis of 11 studies, comprising 1,418 cases and 3,343 controls, showed a significant and positive association between BNP levels and AF (pooled Std.Mean Difference = 1.08; 95% CI = 0.67, 1.49; P < 0.0001), with no publication bias (P = 0.212). Among the subgroups, significant differences in Std. Mean Differences were observed primarily when stratified by region or risk of bias; however, these analyses were unable to fully account for the observed heterogeneity.ConclusionsElevated BNP levels are strongly associated with prevalent AF. In prospective studies measuring BNP prior to onset, elevated levels served as a modest predictor of incident AF, suggesting its role in identifying underlying atrial myopathy. Further investigations in both molecular and clinical fields with proper methodology and more detailed information are needed to clear the interactive aspects of BNP level in AF patients.