Abstract 11712: Plasma Mid-Regional Pro-Atrial Natriuretic Peptide and N-terminal Pro-Brain Natriuretic Peptide Improve Discrimination of Lone Atrial Fibrillation
Purpose: Plasma atrial natriuretic peptide is increased in common atrial fibrillation (AF in older patients with established risk factors). It is unknown whether mid-regional pro-ANP (MRproANP) is associated with lone AF (LAF). We evaluated the association and discriminative ability of MRproANP for LAF, and compared it with N-terminal pro-brain natriuretic peptide (NTproBNP).
Methods: We enrolled patients with LAF (<60 years without hypertension, diabetes, or structural heart disease) and age-, sex-matched non-AF controls. Biomarkers were measured in sinus rhythm. We used logistic regression to assess the association between biomarkers and LAF, and a stepwise selection method to fit the most parsimonious clinical and echocardiographic model to predict LAF. Biomarkers were analyzed as continuous variables, where the natural log (ln) of the biomarkers was used. To assess model discrimination, we estimated the area under the ROC curve (AUC).
Results: We enrolled 81 LAF and 81 controls (median age, 49 and 48 years, respectively; 89% male in both groups). Median MRproANP (71.4 v. 42.4 pmol/L, P<0.0001) and NTproBNP (55.0 v. 26.0 pmol/L, P<0.0001) were higher in LAF than controls. After adjustment for confounders, higher MRproANP and NTproBNP were associated with higher odds of LAF (Table). The AUC (95% CI) of MRproANP for discriminating LAF from controls (0.74 [0.66-0.82]) was not different from NTproBNP (0.73 [0.65-0.81], P=0.82). The most parsimonious clinical and echocardiographic model for prediction of LAF comprised age, BP and LA size (AUC 0.73 [0.65-0.81]). Adding MRproANP improved AUC to 0.81 (0.75-0.88), P=0.01; adding NTproBNP improved AUC to 0.79 (0.72-0.86); P=0.03; adding both improved AUC to 0.82 (0.76-0.89); P=0.01.
Conclusions: Plasma MRproANP and NTproBNP are associated with LAF. Both have good discriminative ability for the presence or absence of LAF.
Author Disclosures: I.C. Chang: None. L.Y. Chen: None. J.P. Chong: None. E. Austin: None. C.N. Quay: None. L. Gong: None. A.M. Richards: None. L.H. Ling: None.
- © 2014 by American Heart Association, Inc.