N-terminal pro-B-type natriuretic peptide as a predictor of incident atrial fibrillation in the Multi-Ethnic Study of Atherosclerosis: the effects of age, sex and ethnicity.

Abstract

OBJECTIVE:

Atrial fibrillation (AF) is a common source of medical costs, morbidity and mortality. NT pro-brain natriuretic peptide (BNP) is a remarkably strong predictor of AF in older whites; we aimed to assess if this biomarker was as predictive in other racial groups.

DESIGN:

We used covariate-adjusted Cox model regressions to estimate the HRs of developing AF as a function of NT proBNP, and tested for interactions of NT proBNP with age, gender and race/ethnicity.

SETTING:

The Multi-Ethnic Study of Atherosclerosis (MESA).

PATIENTS:

5518 subjects were followed over a median of 7.6 years. During this time, 267 developed AF.

RESULTS:

NT proBNP was statistically significantly associated with incident AF; for ln NT proBNP, the adjusted HR was 2.2 (95% CI 1.9 to 2.5). Assessed by quintiles, the relationship between NT proBNP was strong and graded; the unadjusted HR for the highest quintile of NT proBNP was 23.7 (95% CI 11.1 to 50.6) and adjusted was 11.4 (95% CI 5.1 to 25.3). NT proBNP was an excellent predictor of incident AF in the younger and older age groups, in men and women and in the different race/ethnicity groups: the HR for ln NT proBNP as a predictor of incident AF ranged from 2.0 to 3.9 in each subgroup.

CONCLUSIONS:

NT proBNP is a robust predictor of incident AF; its prognostic value is more significant in younger patients and women compared with older patients and men. NT proBNP was also as strongly predictive in black patients, Hispanics and Asian/Chinese as in white patients despite a lower incidence of arrhythmia.

• Authors: Kristen K Patton, Susan R Heckbert, Alvaro Alonso, Hossein Bahrami, Joao A C Lima, Gregory Burke, Richard A Kronmal
• Journal: Heart (British Cardiac Society) (Heart) Vol. 99 Issue 24 Pg. 1832-6 (Dec 2013) ISSN: 1468-201X [Electronic] England
• PMID: 24131775 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Research Support, N.I.H., Extramural)

Chemical References

• Biomarkers
• Peptide Fragments
• Protein Precursors
• pro-brain natriuretic peptide (1-76)
• Natriuretic Peptide, Brain

Topics

• Age Factors
• Aged
• Aged, 80 and over
• Atherosclerosis (blood, complications, ethnology)
• Atrial Fibrillation (blood, ethnology, etiology)
• Biomarkers (blood)
• Ethnicity
• Female
• Follow-Up Studies
• Humans
• Incidence
• Male
• Middle Aged
• Natriuretic Peptide, Brain (blood)
• Peptide Fragments (blood)
• Prognosis
• Prospective Studies
• Protein Precursors
• Risk Factors
• Sex Factors
• Time Factors
• United States (epidemiology)