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N-terminal pro B-type natriuretic peptide in systematic screening for atrial fibrillation
Danderyds Univ Hosp, Dept Clin Sci, Cardiol Unit, Karolinska Inst, Hjartkliniken Plan 2,Hus 18, SE-18288 Stockholm, Sweden..
Danderyds Univ Hosp, Dept Clin Sci, Cardiol Unit, Karolinska Inst, Hjartkliniken Plan 2,Hus 18, SE-18288 Stockholm, Sweden..
Danderyds Univ Hosp, Dept Clin Sci, Cardiol Unit, Karolinska Inst, Hjartkliniken Plan 2,Hus 18, SE-18288 Stockholm, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
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2017 (English)In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 103, no 16, 1271-1277 p.Article in journal (Refereed) Published
Abstract [en]

Objective Screening for atrial fibrillation (AF) in individuals aged 65 and above is recommended by the European Society of Cardiology. Increased levels of the biomarker N-terminal pro B-type natriuretic peptide (NT-proBNP) has in cohort studies been associated with incident AF. The aim of this study was to assess whether NT-proBNP could be useful for AF detection in systematic screening.

Methods The Strokestop study entailed 7173 Swedish residents aged 75/76 that were screened for AF using twice daily intermittent ECG recordings during 2 weeks. In a substudy of 886 participants, the last 815 consecutive participants and 71 individuals with newly detected AF, levels of NT-proBNP were determined.

Results Participants with newly detected AF (n=96) had a median NT-proBNP of 330 ng/L (IQR 121; 634). In individuals without AF (n=742), median NT-proBNP was 171 ng/L (IQR 95; 283), p<0.001. The CHA2DS2-VASc parameters did not differ significantly between individuals with newly detected AF and without AF nor between newly detected AF in the NT-proBNP cohort compared with the cohort where NT-proBNP was not assessed. Using an NT-proBNP cut-off of >= 125 ng/L in a non-acute setting yielded a negative predictive value of 92%, meaning that 35% fewer participants would need to be screened when applied to systematic AF screening. Adding weight to NT-proBNP further reduced participants needed to be screened with a preserved sensitivity.

Conclusions NT-proBNP was increased in individuals with newly detected AF. Prospective studies could clarify if NT-proBNP can be used to correctly select individuals that benefit most from AF screening.

Place, publisher, year, edition, pages
2017. Vol. 103, no 16, 1271-1277 p.
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-332926DOI: 10.1136/heartjnl-2016-310236ISI: 000406309300011PubMedID: 28255099OAI: oai:DiVA.org:uu-332926DiVA: diva2:1157463
Funder
Stockholm County CouncilSwedish Heart Lung Foundation
Available from: 2017-11-16 Created: 2017-11-16 Last updated: 2017-11-16Bibliographically approved

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Hijazi, Ziad

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