Department of Neurology, Matsuyama red-cross hospital, Matsuyama, Ehime, Japan.
Eur J Neurol. 2010 Feb;17(2):326-31. doi: 10.1111/j.1468-1331.2009.02813.x. Epub 2009 Oct 21.
We investigated whether the brain natriuretic peptide (BNP) level can serve as a predictive biological marker of delayed atrial fibrillation (AF).
Two hundred and thirty seven consecutive patients admitted to our institution with acute ischaemic stroke or transient ischaemic attack (TIA) within 24 h of onset were enrolled. The patients were classified according to the presence or absence of AF upon admission [AF and sinus rhythm (SR) groups]. The SR group was subdivided based on the development of AF after admission (new- and non-AF groups). We compared the characteristics between the AF and SR groups, and between the new- and non-AF groups. The factors associated with new-AF were investigated by multivariate logistic regression analysis.
Amongst the enrolled patients, 72 (30.4%) had AF upon admission (AF group), and 13 (5.5%) developed AF thereafter (new-AF group). The plasma BNP level was significantly higher in the AF, than in the SR group (401.7 vs. 92.1 pg/ml, P < 0.001). Moreover, the plasma BNP level was significantly higher in the new-, than in the non-AF group (184.7 vs. 84.1 pg/ml, P < 0.001). The optimal cutoff BNP level required to distinguish new-, from non-AF groups was 85.0 pg/ml, and the sensitivity and specificity was 83.3% and 76.2%, respectively. On multivariate logistic regression analysis, plasma BNP level >85.0 pg/ml (odds ratio, 7.20; 95% confidence interval, 1.71 to 30.43, P = 0.007) was an independent factor associated with new-AF.
High plasma BNP level should be a strong predictor of delayed AF after ischaemic stroke or TIA.
我们研究了脑钠肽（BNP）水平是否可作为预测心房颤动（AF）延迟发生的生物标志物。
我们纳入了 237 例在发病后 24 小时内因急性缺血性卒中和短暂性脑缺血发作（TIA）而入院的连续患者。根据入院时是否存在 AF 将患者进行分类[AF 和窦性心律（SR）组]。根据入院后 AF 的发展情况，SR 组进一步分为新发 AF 和非 AF 组。我们比较了 AF 和 SR 组之间以及新发 AF 和非 AF 组之间的特征。采用多变量 logistic 回归分析来探讨与新发 AF 相关的因素。
在纳入的患者中，72 例（30.4%）入院时存在 AF（AF 组），13 例（5.5%）随后出现 AF（新发 AF 组）。AF 组的血浆 BNP 水平显著高于 SR 组（401.7 比 92.1 pg/ml，P<0.001）。此外，新发 AF 组的血浆 BNP 水平显著高于非 AF 组（184.7 比 84.1 pg/ml，P<0.001）。区分新发 AF 和非 AF 组的最佳 BNP 截断值为 85.0 pg/ml，其灵敏度和特异度分别为 83.3%和 76.2%。多变量 logistic 回归分析显示，血浆 BNP 水平>85.0 pg/ml（优势比，7.20；95%置信区间，1.71 至 30.43，P=0.007）是与新发 AF 相关的独立因素。
高血浆 BNP 水平应是缺血性卒中和 TIA 后发生延迟性 AF 的强烈预测因素。
