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. 2019 Mar;34(3):517-526.
doi: 10.1007/s00380-018-1267-5. Epub 2018 Sep 20.

Pre-ablation levels of brain natriuretic peptide are independently associated with the recurrence of atrial fibrillation after radiofrequency catheter ablation in patients with nonvalvular atrial fibrillation

Junichiro Miake  1 , Masaru Kato  2 , Kazuyoshi Ogura  2 , Kazuhiko Iitsuka  2 , Akihiro Okamura  2 , Takuya Tomomori  2 , Daiki Tsujimoto  2 , Masahiko Kato  2 , Kazuhiro Yamamoto  2
Affiliations

Pre-ablation levels of brain natriuretic peptide are independently associated with the recurrence of atrial fibrillation after radiofrequency catheter ablation in patients with nonvalvular atrial fibrillation

Junichiro Miake et al. Heart Vessels. 2019 Mar.

Abstract

Association between pre-ablation levels of biomarkers of cardiac and endothelial dysfunctions, CHADS2, CHA2DS2-VASc, and APPLE scores and the recurrence of atrial fibrillation (AF) after radiofrequency catheter ablation has not been fully studied. A total of 254 patients with nonvalvular AF were prospectively followed for AF recurrence after a single ablation procedure. During a two-year follow-up period, AF recurred in 65 (25.6%) patients. Patients with AF recurrence had significantly greater baseline ln brain natriuretic peptide (BNP) than those without AF recurrence (P < 0.01), whereas there were no significant differences in the levels of biomarkers of endothelial dysfunction and points of scoring systems. In the Cox regression analyses, the baseline ln BNP was significantly independently associated with AF recurrence (adjusted HR =1.286, 95% CI =1.000-1.655, P < 0.05). The baseline levels of ln BNP were significantly associated with rhythm at blood collection, age, sex, and left atrial diameter, and left ventricular ejection fraction (P < 0.05).The subgroup analysis showed a significant interaction on the risk of AF recurrence between ln BNP, sex difference, and rhythm at blood collection (P for interaction < 0.05). In conclusion, the results suggest that the pre-ablation levels of ln BNP are useful to evaluate the risk of AF recurrence after ablation therapy; however, there is a need to be careful while using BNP as a biomarker for the risk of AF recurrence by taking account of the effects of rhythm status at blood collection and sex difference.

Keywords: Atrial fibrillation; Biomarkers; Brain natriuretic peptide; Catheter ablation; Recurrence.

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Conflict of interest statement

Conflict of interest

The authors have no conflict of interest to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Figures

Fig. 1
Fig. 1
Probability of remaining free of the recurrence of AF in patients with the lower and higher levels of BNP. Patients were divided into two groups by the median concentration of BNP. Patient with lower level of BNP had a greater probability of remaining free of the recurrence of AF than those with higher level of BNP (P value by log-rank test = 0.011). Two-year recurrence-free survival rates were 0.812 (95% CI = 0.730–0.871) and 0.672 (95% CI = 0.578–0.749) in patients with the lower and higher levels of BNP, respectively. BNP brain natriuretic peptide
See this image and copyright information in PMC

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