Abstract 2518: Plasma B-type Natriuretic Peptide Levels Predict Atrial fibrillation in a Population-Based cohort
Background: Early detection of subjects at high risk for development of atrial fibrillation (AF) offers the perspective of prevention of serious complications related to AF. B-type natriuretic peptide (BNP) is secreted from cardiomyocytes and may reflect structural abnormalities predisposing to AF. We aimed to investigate whether N-terminal pro BNP (NT-proBNP) is predictive for AF in a community-based population.
Methods From the PREVEND program (n=8,592), we selected all subjects with an available baseline and 4-year electrocardiogram and NT-proBNP levels at baseline. In addition, we excluded subjects with AF at baseline and subjects with a serum creatinine of more than 2.0 mg/dl. AF was defined according to Minnesota codes. NT-proBNP was entered both continuously after natural logarithmic transformation as well as categorical (above and below sex-specific 80th percentile values) in logistic regression models. NT-proBNP was measured using an electrochemiluminiscence immunoassay (Roche Diagnostics) on an Elecsys 2010 analyzer.
Results In total, 6,503 subjects were eligible for the current analysis (age 49 ± 12 years, 49.7 % men). At 4-years, AF was detected in 42 (0.6%) subjects who had no AF at baseline. Age and gender adjusted geometric mean of NT-proBNP at baseline in subjects with AF after 4-years was 70.0 ± 3.9 pg/ml as compared to 33.2 ± 2.9 pg/ml in the control group (p<0.001). Each 1 standard deviation increment in log transformed NT-proBNP was associated with a 74 % (25% to 141% 95CI, p =0.001) increase in the risk of AF after adjustment for age and gender and a 64% (14% to 135%, p=0.007) increase was observed after adjustment for other risk factors predisposing to AF (e.g. age, gender, electrocardiographic left ventricular hypertrophy, diastolic blood pressure, C-reactive protein, albuminuria, serum creatinine levels). NT-proBNP levels above the sex-specific 80th percentile (100 pg/ml in women and 69 pg/ml in men) was associated with a multivariate odds ratio of 2.56 [1.24 − 5.30, p=0.011] for the occurrence of AF after 4-years.
Conclusions Plasma levels of NT-proBNP predict future AF in a population-based cohort independent of other risk factors predisposing to AF.