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Title

N-Terminal Pro B-Type Natriuretic Peptide's Usefulness for Paroxysmal Atrial Fibrillation Detection Among Populations Carrying Cardiovascular Risk Factors

AuthorsPalà, Elena; Bustamante, Alejandro; Clúa-Espuny, Josep Lluis; Acosta, Juan; Gonzalez-Loyola, Felipe; Ballesta-Ors, Juan; Gill, Natalia; Caballero, Andrea; Pagola, Jorge; Pedrote, Alonso; Muñoz, Miguel Ángel; Montaner, Joan
KeywordsStroke
Atrial fibrillation
Biomarker
Screening
NT-proBNP
Issue DateNov-2019
PublisherFrontiers Media
CitationFrontiers in Neurology 10: 1226 (2019)
Abstract[Background]: Atrial fibrillation (AF) systematic screening studies have not shown a clear usefulness in stroke prevention, as AF might present as paroxysmal and asymptomatic. This study aims to determine the usefulness of some blood-biomarkers to identify paroxysmal atrial fibrillation in the context of a screening programme.
[Methods]: A total of 100 subjects aged 65–75 years with hypertension and diabetes were randomly selected. AF was assessed by conventional electrocardiogram (ECG) and 4 weeks monitoring with a wearable Holter device (Nuubo™). N-terminal pro B-type natriuretic peptide (NT-proBNP), apolipoprotein CIII (ApoC-III), von Willebrand factor (vWF), ADAMTS13, urokinase plasminogen activator surface receptor (uPAR), and urokinase plasminogen activator (uPA) were determined in serum/plasma samples and the levels were compared depending on AF presence and mode of detection.
[Results]: The AF prevalence in the studied population was found to be 20%. In seven subjects, AF was only detected after 1 month of Holter monitoring (hAF group). NT-proBNP levels were higher in subjects with AF compared with subjects with no AF (p < 0.0001), even when only taking into account the hAF group (p = 0.031). No significant differences were found in the other biomarkers. The NT-proBNP >95 pg/ml cut-off showed high sensitivity and specificity to detect AF (95%, 66.2%) or hAF (85.72%, 66.2%) and was found to be an independent predictor of AF and hAF in a logistic regression analysis. NT-proBNP correlated with AF burden (r = 0.597, p = 0.024).
[Conclusion]: NT-proBNP was elevated in AF cases not identified by ECG; thus, it may be used as a screening biomarker in asymptomatic high-risk populations, with a promising cut-off point of 95 pg/ml that requires further validation.
DescriptionCopyright © 2019 Palà, Bustamante, Clúa-Espuny, Acosta, Gonzalez-Loyola, Ballesta-Ors, Gill, Caballero, Pagola, Pedrote, Muñoz and Montaner
Publisher version (URL)http://dx.doi.org/10.3389/fneur.2019.01226
URIhttp://hdl.handle.net/10261/214230
DOIhttp://dx.doi.org/10.3389/fneur.2019.01226
E-ISSN1664-2295
Appears in Collections:(IBIS) Artículos
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