THE RELATIONSHIP BETWEEN N-TERMINAL PRO-B-TYPE NATRIURETIC PEPTIDE AT ADMISSION AND CARDIOVASCULAR EVENTS IN PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION

Thị Thu Hoài Nguyễn1,2,, Thị Thủy Nguyễn3, Thị Thơm Vũ 2
1 Bach Mai hospital
2 VNU - School of Medicine and Pharmacy
3 Hanoi medical university

Main Article Content

Abstract

Background: Atrial fibrillation (AF), the most common cardiac rhythm abnormality, increases cardiovascular events such as death, stroke, systemic embolism, heart failure. Plasma N-terminal pro-B-type Natriuretic Peptide (NT-proBNP) level is an independent prognostic factor capable of predicting cardiovascular events in patients with non-valvular atrial fibrillation. Aim: To study the relationship between plasma NT-proBNP level at admission and cardiovascular events in patients with non-valvular AF. Methods: 200 patients with non-valvular AF were tested for NT-proBNP at admission. All patients were followed on 6 months. We studied the relationship between NT-proBNP and the rate of hospital re-admission due to cardiovascular events. Results: The NT-proBNP level in the group of general cardiovascular events was higher than non-event group (1024,98 ± 1204,36 pmol/l vs 161,31 ± 207,92 pmol/L, p = 0.000. Each increase of 100pmol/L concentration of NT-proBNP, the general cardiovascular event increased 2.5 times (OR = 2,513; 95%CI 1,561 - 2,821; p = 0,000. At cut-off 311 pmol/L, AUC 0.848, sensitivity, specificity, positive predictive value, negative predictive value: 70%; 91%; 83%; 83%, respectively). Conclusion: NT-proBNP is an independent prognostic factor in patients with atrial fibrillation non-valvular heart disease.

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References

1. Go A.S., Hylek E.M., Phillips K.A. et al. Prevalence of Diagnosed Atrial Fibrillation in Adults: National Implications for Rhythm Management and Stroke Prevention: the AnTicoagulation and Risk Factors In Atrial Fibrillation (ATRIA) Study. JAMA 2001, 285(18), 2370–2375.
2. Wolf P A, Abbott R D, và Kannel W B (1991). Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke 1991; 22(8), 983–988.
3. Lake F.R., Cullen K.J., Klerk N.H. et al. Atrial Fibrillation and Mortality in an Elderly Population. Australian and New Zealand Journal of Medicine, 1989; 19(4), 321–326.
4. Kirchhof P., Schmalowsky J., Pittrow D et al. (2014). Management of Patients With Atrial Fibrillation by Primary-Care Physicians in Germany: 1-Year Results of the ATRIUM Registry. Clinical Cardiology 2014; 37(5), 277–284.
5. Patton K.K., Ellinor P.T., Heckbert S.R. et al. N-terminal pro-B-type Natriuretic Peptide is a Major Predictor of the Development of Atrial Fibrillation: The Cardiovascular Health Study. Circulation 2009; 120(18), 1768–1774.
6. Amin A.N., Jhaveri M., và Lin J. Hospital Readmissions in US Atrial Fibrillation Patients: Occurrence and Costs. American Journal of Therapeutics 2013; Vol 8.
7. Bettencour P. et al. NT-proBNP and BNP: biomarkers for heart failure management. Eur J Heart Fail. 2004; Mar 15;6(3):359-63.
8. Luchner A, Behren G. et al. Long-term pattern of brain natriuretic peptide and N-terminal pro brain natriuretic peptide and its determinants in the general population: contribution of age, gender, and cardiac and extra-cardiac factors. Eur J Heart Fail. 2014; 15 (8): 859-867
9. Januzzi JL, Kimenade R., et al. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: An international pooled analysis of 1256 patients: The International Collaborative of NT-proBNP Study. European Heart Journal 2006 27(3):330-337
10. Masson S. và Latini R. (2008). Amino-Terminal Pro–B-Type Natriuretic Peptides and Prognosis in Chronic Heart Failure. The American Journal of Cardiology, 101(3, Supplement), S56–S60.