02964nas a2200385 4500008004100000022001400041245014300055210006900198260001600267300001200283490000800295520179300303653000902096653002202105653002402127653001102151653001102162653001602173653002502189653000902214653003102223653002202254653003002276653001502306653003202321653001702353100002302370700002402393700002302417700002702440700002702467700002402494700002402518856003602542 2009 eng d a1524-453900aN-terminal pro-B-type natriuretic peptide is a major predictor of the development of atrial fibrillation: the Cardiovascular Health Study.0 aNterminal proBtype natriuretic peptide is a major predictor of t c2009 Nov 03 a1768-740 v1203 a
BACKGROUND: Atrial fibrillation (AF), the most common cardiac rhythm abnormality, is associated with significant morbidity, mortality, and healthcare expenditures. Elevated B-type natriuretic peptide levels have been associated with the risk of heart failure, AF, and mortality.
METHODS AND RESULTS: The relation between N-terminal pro-B-type natriuretic peptide (NT-proBNP) and AF was studied in 5445 Cardiovascular Health Study participants with the use of relative risk regression for predicting prevalent AF and Cox proportional hazards for predicting incident AF. NT-proBNP levels were strongly associated with prevalent AF, with an unadjusted prevalence ratio of 128 for the highest quintile (95% confidence interval, 17.9 to 913.3; P<0.001) and adjusted prevalence ratio of 147 for the highest quintile (95% confidence interval, 20.4 to 1064.3; P<0.001) compared with the lowest. After a median follow-up of 10 years (maximum of 16 years), there were 1126 cases of incident AF (a rate of 2.2 per 100 person-years). NT-proBNP was highly predictive of incident AF, with an unadjusted hazard ratio of 5.2 (95% confidence interval, 4.3 to 6.4; P<0.001) for the development of AF for the highest quintile compared with the lowest; for the same contrast, NT-proBNP remained the strongest predictor of incident AF after adjustment for an extensive number of covariates, including age, sex, medication use, blood pressure, echocardiographic parameters, diabetes mellitus, and heart failure, with an adjusted hazard ratio of 4.0 (95% confidence interval, 3.2 to 5.0; P<0.001).
CONCLUSIONS: In a community-based population of older adults, NT-proBNP was a remarkable predictor of incident AF, independent of any other previously described risk factor.
10aAged10aAged, 80 and over10aAtrial Fibrillation10aFemale10aHumans10aImmunoassay10aLongitudinal Studies10aMale10aNatriuretic Peptide, Brain10aPeptide Fragments10aPredictive Value of Tests10aPrevalence10aProportional Hazards Models10aRisk Factors1 aPatton, Kristen, K1 aEllinor, Patrick, T1 aHeckbert, Susan, R1 aChristenson, Robert, H1 aDeFilippi, Christopher1 aGottdiener, John, S1 aKronmal, Richard, A uhttps://chs-nhlbi.org/node/1138