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. 2023 Jun;19(2):163-170.
doi: 10.5114/aic.2023.125317. Epub 2023 Feb 23.

Predictive value of pre-procedural N-terminal pro-B-type natriuretic peptide level for atrial fibrillation recurrence after radiofrequency catheter ablation

Qing Zhao  1   2 , Wentao Yang  3 , Xiangdong Li  1 , Minghui Yao  2 , Jianping Guo  2 , Yutang Wang  4 , Zhaoliang Shan  2
Affiliations

Predictive value of pre-procedural N-terminal pro-B-type natriuretic peptide level for atrial fibrillation recurrence after radiofrequency catheter ablation

Qing Zhao et al. Postepy Kardiol Interwencyjnej. 2023 Jun.

Abstract

Introduction: N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been demonstrated as a valuable risk marker for mortality and morbidity of cardiovascular disease. Recurrence after atrial fibrillation (AF) radiofrequency catheter ablation remains common.

Aim: We investigated the predictive value of the pre-procedural level of NT-proBNP to differentiate high-risk patients for post-ablation AF recurrence.

Material and methods: 326 individuals with nonvalvular AF and preserved systolic function after enduring an initial radiofrequency catheter ablation (RFCA) between March 2018 and December 2019 were categorized into a recurrent group and a non-AF recurrent group. The serum NT-proBNP levels were examined before the ablation procedure. The researchers used multivariate logistic regression to find the determinants of AF recurrence.

Results: During a 14-month (interquartile range (IQR): 12-16) median follow-up, AF recurred in 84 (25.8%) patients. Patients in the recurrence group had considerably greater pre-ablation NT-proBNP levels (389.4 vs. 141.7 pg/ml, p < 0.001 in non-paroxysmal AF and 348.0 vs. 99.4 pg/ml, p < 0.001 in paroxysmal AF) as well as a greater left atrium (40 vs. 36 mm, p = 0.01 in non-paroxysmal AF and 38 vs. 36 mm, p = 0.01 in paroxysmal AF) than the non-AF recurrence group. A cut-off value of NT-proBNP ≥ 168.05 pg/ml identified AF recurrence with a sensitivity of 78.6% and specificity of 53.7% (area under ROC curve 0.68, 95% confidence interval (CI) 0.62-0.74, p < 0.001). Kaplan-Meier examination revealed that the elevated NT-proBNP (≥ 168.05 pg/ml) group presented a considerably shorter period without an occurrence compared to the low-NT-proBNP group (18.4 vs. 22.2 months, log-rank p = 0.001). Multivariate cox regression investigation showed that a level of NT-proBNP ≥ 168.05 pg/ml (hazard ratio (HR): 2.89, 95% CI: 1.71-4.903, p < 0.001) was a reliable predictor of AF recurrence after RFCA.

Conclusions: A high pre-ablation NT-proBNP level was associated with AF recurrence, and it was also discovered to be a prognostic factor of recurrence of AF following RFCA.

Keywords: N-terminal pro-B-type natriuretic peptide; atrial fibrillation; radiofrequency catheter ablation; recurrence.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The summary of the process of study participants
Figure 2
Figure 2
ROC curve examination assessing the NT-proBNP value in predicting AF recurrence NT-proBNP – N-terminal probrain natriuretic peptide, ROC – receiver operating characteristic, AF – atrial fibrillation, CI – confidence interval, AUC – area under the curve.
Figure 3
Figure 3
Kaplan-Meier curve revealing atrial fibrillation-free according to NT-proBNP categories (< 168.05 and ≥ 1 68.05 pg/ml) NT-proBNP – N-terminal pro-brain natriuretic peptide, AF – atrial fibrillation.
See this image and copyright information in PMC

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References

    1. Packer DL, Mark DB, Robb RA, et al. . Effect of catheter ablation vs antiarrhythmic drug therapy on mortality, stroke, bleeding, and cardiac arrest among patients with atrial fibrillation: The CABANA randomized clinical trial. JAMA 2019; 321: 1261-74. - PMC - PubMed
    1. Pallisgaard JL, Gislason GH, Hansen J, et al. . Temporal trends in atrial fibrillation recurrence rates after ablation between 2005 and 2014: a nationwide Danish cohort study. Eur Heart J 2018; 39: 442-9. - PubMed
    1. Kizilirmak F, Gokdeniz T, Gunes HM, et al. . Myocardial injury biomarkers after radiofrequency catheter and cryoballoon ablation for atrial fibrillation and their impact on recurrence. Kardiol Pol 2017; 75: 126-34. - PubMed
    1. Wu N, Xu B, Xiang Y, et al. . Association of inflammatory factors with occurrence and recurrence of atrial fibrillation: a meta-analysis. Int J Cardiol 2013; 169: 62-72. - PubMed
    1. Staerk L, Preis SR, Lin H, et al. . Protein biomarkers and risk of atrial fibrillation: the FHS. Circ Arrhythm Electrophysiol 2020; 13: e007607. - PMC - PubMed