In emergency department patients with AF, high NT-proBNP (>500 pmol/L) was independently associated with increased mortality (HR 2.26; 95% CI 1.19-4.28) compared with low values (<250 pmol/L).
Cohort (n=355)
Does elevated NT-proBNP predict mortality and major adverse cardiac events in patients presenting to the emergency department with atrial fibrillation?
In patients presenting to the emergency department with atrial fibrillation, elevated NT-proBNP is an independent predictor of mortality and major adverse cardiac events.
Effect estimate: HR 2.26 (95% CI 1.19-4.28)
BACKGROUND: -VASc score helps to predict thromboembolic risk; however, the rate of other adverse cardiac events is more difficult to predict. HYPOTHESIS: The biomarker N-terminal pro-brain natriuretic peptide (NT-proBNP) has prognostic value in patients presenting to the emergency department with AF. METHODS: During a 1.5-year period, a prospective study was performed in consecutive patients presenting to the emergency department with AF on the presenting electrocardiogram. At baseline, NT-proBNP was measured. The primary endpoints were all-cause death and major adverse cardiac events (MACE: all-cause mortality, myocardial infarction, or revascularization). RESULTS: A total of 355 patients were included (mean age, 71 years; 55% male). The median duration of follow-up was 2 years. After adjustment for baseline variables, the logNT-proBNP was independently correlated with death (hazard ratio HR: 1.54, 95% confidence interval CI: 1.18-1.99) and MACE (HR: 1.27, 95% CI: 1.03-1.58). After adjustment for baseline variables, a high NT-proBNP value (>500 pmol/L) was independently correlated with death (HR: 2.26, 95% CI: 1.19-4.28), and for MACE a trend was seen (HR: 1.67, 95% CI: 0.96-2.91) compared with a low value (<250 pmol/L). CONCLUSIONS: In patients presenting to the emergency department with AF, higher NT-proBNP values are independently associated with an increased mortality and MACE. Therefore, this biomarker may be a useful prognostic marker in the management and treatment of these patients.
Holl et al. (Mon,) conducted a cohort in Atrial fibrillation (n=355). High NT-proBNP (>500 pmol/L) vs. Low NT-proBNP (<250 pmol/L) was evaluated on All-cause death (HR 2.26, 95% CI 1.19-4.28). In emergency department patients with AF, high NT-proBNP (>500 pmol/L) was independently associated with increased mortality (HR 2.26; 95% CI 1.19-4.28) compared with low values (<250 pmol/L).