Open AccessNT‐proBNP is associated with mortality and adverse cardiac events in patients with atrial fibrillation presenting to the emergency department
Author(s) -
Holl Marijn J.,
van den Bos Ewout J.,
van Domburg Ron T.,
Fouraux Michael A.,
Kofflard Marcel J.
Publication year - 2018
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.22883
Subject(s) - medicine , mace , emergency department , hazard ratio , atrial fibrillation , myocardial infarction , cardiology , prospective cohort study , confidence interval , natriuretic peptide , biomarker , heart failure , percutaneous coronary intervention , biochemistry , chemistry , psychiatry
Background Atrial fibrillation (AF) is the most common cardiac arrhythmia in the emergency department. The CHA 2 DS 2 ‐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.