Bibliographic Details
| Title: |
Predictive Value of N-Terminal Pro B-Type Natriuretic Peptide for Short-Term Outcome of Cardioversion in Patients with First-Diagnosed or Paroxysmal Atrial Fibrillation Presenting to the Emergency Department |
| Authors: |
Antonios Diakantonis, Christos Verras, Sofia Bezati, Vasiliki Bistola, Ioannis Ventoulis, Maria Velliou, Antonios Boultadakis, Ignatios Ikonomidis, John T. Parissis, Effie Polyzogopoulou |
| Source: |
Biomedicines, Vol 12, Iss 12, p 2895 (2024) |
| Publisher Information: |
MDPI AG, 2024. |
| Publication Year: |
2024 |
| Collection: |
LCC:Biology (General) |
| Subject Terms: |
NT-proBNP, atrial fibrillation, cardioversion, emergency department, Biology (General), QH301-705.5 |
| More Details: |
Background: Atrial fibrillation (AF) is a common arrhythmia in the emergency department (ED). We investigated the role of N-terminal pro b-type natriuretic peptide (NT-proBNP) in predicting both the outcome of AF cardioversion and the risk of AF recurrence or persistence on the 8th (D8) and 30th (D30) day post-cardioversion. Methods: This prospective, observational study evaluated patients with recent-onset AF, managed by either pharmacological (PC) or electrical cardioversion (EC) in the ED. Patients were treated either immediately or electively after 3 weeks of anticoagulation. NT-proBNP assessments were performed prior to cardioversion. Results: Of the 148 patients enrolled, 56% had paroxysmal AF, 85% underwent immediate cardioversion and 72% received EC. Successful cardioversion to sinus rhythm (SR) was achieved in 85% of patients. Patients with successful cardioversion and those who remained free from AF on D8 had lower NT-proBNP levels compared to patients with failed cardioversion or with AF recurrence or persistence on D8 [day of cardioversion, D0: SR vs. non-SR, 387 (127–1095) pg/mL vs. 1262 (595–2295), p = 0.004; D8: SR vs. non-SR, 370 (127–1095) vs. 1366 (718–2295), p = 0.002]. In multivariate analysis, higher logNT-proBNP was associated with higher risk of cardioversion failure [OR, 95%CI: 4.80 (1.58–14.55), p = 0.006] and AF recurrence or persistence on D8 [OR, 95%CI: 3.65 (1.06–12.59), p = 0.041]. ROC analysis confirmed the predictive ability of NT-proBNP for both outcomes (D0: AUC 0.735, p < 0.001; D8: AUC 0.761, p < 0.001). A cut-off value of NT-proBNP > 580 pg/mL was able to predict failure of AF conversion and occurrence of recurrent/persistent AF at D8. Conclusions: NT-proBNP is a promising biomarker for identifying patients presenting to the ED with recent-onset AF who run a greater risk of cardioversion failure and post-discharge AF recurrence/persistence in the immediate and short term. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
2227-9059 |
| Relation: |
https://www.mdpi.com/2227-9059/12/12/2895; https://doaj.org/toc/2227-9059 |
| DOI: |
10.3390/biomedicines12122895 |
| Access URL: |
https://doaj.org/article/d87c0a77501648d9aac6fd0a1282b106 |
| Accession Number: |
edsdoj.87c0a77501648d9aac6fd0a1282b106 |
| Database: |
Directory of Open Access Journals |
