NT‐proBNP as a marker for atrial fibrillation and heart failure in four observational outpatient trials

• Published in: ESC Heart Failure 2022-02, Vol.9 (1), p.100-109
• Main Authors: Werhahn, Stefanie M., Becker, Christian, Mende, Meinhard, Haarmann, Helge, Nolte, Kathleen, Laufs, Ulrich, Zeynalova, Samira, Löffler, Markus, Dagres, Nikolaos, Husser, Daniela, Dörr, Marcus, Gross, Stefan, Felix, Stephan B., Petersmann, Astrid, Herrmann‐Lingen, Christoph, Binder, Lutz, Scherer, Martin, Hasenfuß, Gerd, Pieske, Burkert, Edelmann, Frank, Wachter, Rolf
• Format: Article
• Language: English
• Subjects: Aged; Atrial fibrillation; Atrial Fibrillation - complications; Atrial Fibrillation - diagnosis; Atrial Fibrillation - epidemiology; Biomarker; Biomarkers; Blood pressure; Brain natriuretic peptide; Cardiac arrhythmia; Chronic illnesses; Cohort analysis; Diabetes; Disease; Electrocardiography; Female; Heart failure; Heart Failure - complications; Heart Failure - diagnosis; Heart Failure - epidemiology; Humans; Hypertension; Male; Medical records; Middle Aged; Natriuretic Peptide, Brain; Original; Outpatients; Peptide Fragments; Peptides; Population-based studies; Population‐based cohort studies; Prospective Studies; Risk factors; Software
• ISSN: 2055-5822; 2055-5822
• DOI: 10.1002/ehf2.13703

Aims Heart failure (HF) and atrial fibrillation (AF) frequently coexist and are both associated with increased levels of N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP). It is known that AF impairs the diagnostic accuracy of NT‐proBNP for HF. The aim of the present study was to compare the diagnostic and predictive accuracy of NT‐proBNP for HF and AF in stable outpatients with cardiovascular risk factors. Methods and results Data were obtained from the DIAST‐CHF trial, a prospective cohort study that recruited individuals with cardiovascular risk factors and followed them up for 12 years. Data were validated in three independent population‐based cohorts using the same inclusion/exclusion criteria: LIFE‐Adult (n = 2869), SHIP (n = 2013), and SHIP‐TREND (n = 2408). Serum levels of NT‐proBNP were taken once at baseline. The DIAST‐CHF study enrolled 1727 study participants (47.7% female, mean age 66.9 ± 8.1 years). At baseline, patients without AF or HF (n = 1375) had a median NT‐proBNP of 94 pg/mL (interquartile range 51;181). In patients with AF (n = 93), NT‐proBNP amounted to 667 (215;1130) pg/mL. It was significantly higher than in the first group (P