The role of NT-proBNP in screening for atrial fibrillation in hypertensive disease

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2024-12-01 DOI:10.1016/j.ijcha.2024.101549

Gina Sado , Katrin Kemp Gudmundsdottir , Carl Bonander , Mattias Ekström , Johan Engdahl , Emma Svennberg

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引用次数: 0

Abstract

Background

Atrial fibrillation (AF) screening should be considered in elderly patients with high risk of stroke, which include individuals with hypertension. The biomarker N-terminal prohormone of brain natriuretic peptide (NT-proBNP) can predict incident AF and is increased in hypertensive individuals. The aim of this study is to investigate the incidence of screening-detected AF in elderly individuals in relation to NT-proBNP and hypertension.

Methods

STROKESTOP II is a randomized controlled trial in which 75/76-years-old individuals were invited to a screening study for AF using NT-proBNP as a discriminator of high risk. In this sub-study, a prior hypertension diagnosis was self-reported by participants and measured blood pressure was stratified into hypertension-grades. Individuals with both increased blood pressure (≥140 mmHg) and NT-proBNP ≥ 125 ng/L were defined as a high-risk group. The lowest risk-group was defined as normotensive participants with NT-proBNP < 125 ng/L.

Results

NT-proBNP increased gradually for every hypertension-grade above hypertension-grade 1 compared to normotensive participants. Screening-detected AF was most common in normotensive participants with increased NT-proBNP (n = 90/1922, 4.7 %), followed by patients with both NT-proBNP > 125 ng/l and SBP ≥ 140 mmHg, (AF = 65/1741, 3.7 %) compared to the low-risk group (AF = 2/1444, 0.1 %), p < 0.001.

Conclusion

NT-proBNP is elevated in elderly patients with hypertension and increases with grades of hypertensive disease. NT-proBNP is a strong predictor of AF regardless of high blood pressure, and the risk for screening-detected AF is very low in participants with normal blood pressure and low NT-proBNP. A combination of blood pressure and NT-proBNP could identify suitable participants for AF screening.

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NT-proBNP在高血压疾病房颤筛查中的作用

背景：老年卒中高危患者（包括高血压患者）应考虑房颤筛查。脑利钠肽n端原激素（NT-proBNP）可以预测房颤的发生，并且在高血压个体中升高。本研究的目的是探讨老年人筛查检测到的房颤发病率与NT-proBNP和高血压的关系。方法strokestop II是一项随机对照试验，邀请75/76岁的个体使用NT-proBNP作为鉴别高风险的AF筛查研究。在这个亚研究中，参与者自我报告先前的高血压诊断，并将测量的血压分层为高血压等级。血压升高（≥140 mmHg）且NT-proBNP≥125 ng/L的个体被定义为高危组。最低风险组定义为NT-proBNP和lt；125 ng / L。结果1级以上高血压患者的snt - probnp均较正常高血压患者逐渐升高。筛查检测到房颤最常见于NT-proBNP升高的正常血压参与者（n = 90/1922, 4.7%），其次是NT-proBNP和gt；125 ng/l和收缩压≥140 mmHg，（AF = 65/1741, 3.7%）与低危组（AF = 2/1444, 0.1%）相比，p <；0.001.结论nt - probnp在老年高血压患者中升高，并随高血压疾病的加重而升高。NT-proBNP是房颤的一个强有力的预测因子，与高血压无关，在血压正常且NT-proBNP低的参与者中，筛查检测到房颤的风险非常低。结合血压和NT-proBNP可以确定合适的参与者进行房颤筛查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.