Akbar Fawad, Lal Deepak, Arshad Muhammad, Imran Maryum, Zaman Muhammad Haidar, Usmani Sauda, Shakeel Ahmed Moazama, Khan Fahad R
Cardiology, Tehsil Headquarter (THQ) Tangi, Government of Khyber Pakhtunkhwa, Peshawar, PAK.
Cardiology, National Institute of Cardiovascular Heart Disease, Karachi, PAK.
Cureus. 2024 Jun 17;16(6):e62515. doi: 10.7759/cureus.62515. eCollection 2024 Jun.
Introduction Atrial fibrillation (AF) is a major global health concern, and early prediction is essential for managing high-risk individuals. N-terminal prohormone of brain natriuretic peptide (NT-proBNP) has emerged as a crucial biomarker for predicting AF. While most studies have concentrated on cohorts already diagnosed with AF or other cardiac diseases, this research investigates the predictive value of NT-proBNP for AF development in a population without prior AF diagnosis. Methods and materials A five-year prospective observational study was conducted on 4090 individuals aged 45 to 75 with no previous diagnosis of AF. Baseline demographic characteristics, comorbid conditions, cardiac-specific measures, and NT-proBNP levels were systematically recorded. The primary endpoint was the onset of AF, confirmed through annual 12-lead ECG or 24-hour Holter monitoring. Univariate and multivariate analyses identified factors associated with AF onset. Results Out of the total population, 16.6% (679 individuals) developed AF. Notably, increased NT-proBNP levels (P=0.001), older age (P=0.001), and hypertension (P=0.001) were significantly associated with the onset of AF. The mean NT-proBNP levels in the AF group were significantly higher than in the non-AF group (P<0.001). The AF group also showed a higher mean age and a greater prevalence of hypertension (P<0.001 for both). Conclusion This study confirms the predictive value of NT-proBNP for AF onset in a non-AF population, highlighting older age and hypertension as significant risk factors for AF development. The findings underscore the potential of NT-proBNP not only as a predictive biomarker but also as a therapeutic target. These insights emphasize the potential role of NT-proBNP in early intervention and management strategies for AF, suggesting that future research should include additional variables, such as lifestyle factors and genetic predisposition, in assessing AF risk.
引言
心房颤动（AF）是全球主要的健康问题，早期预测对于管理高危个体至关重要。脑钠肽前体N末端（NT-proBNP）已成为预测房颤的关键生物标志物。虽然大多数研究集中在已诊断为房颤或其他心脏病的队列中，但本研究调查了NT-proBNP在未预先诊断为房颤的人群中对房颤发生的预测价值。
方法与材料
对4090名年龄在45至75岁且既往未诊断为房颤的个体进行了为期五年的前瞻性观察研究。系统记录了基线人口统计学特征、合并症、心脏特异性指标和NT-proBNP水平。主要终点是房颤的发作，通过每年的12导联心电图或24小时动态心电图监测确诊。单因素和多因素分析确定了与房颤发作相关的因素。
结果
在总人口中，16.6%（679人）发生了房颤。值得注意的是，NT-proBNP水平升高（P=0.001）、年龄较大（P=0.001）和高血压（P=0.001）与房颤发作显著相关。房颤组的平均NT-proBNP水平显著高于非房颤组（P<0.001）。房颤组的平均年龄也较高，高血压患病率也更高（两者均P<0.001）。
结论
本研究证实了NT-proBNP在非房颤人群中对房颤发作的预测价值，强调年龄较大和高血压是房颤发生的重要危险因素。研究结果强调了NT-proBNP不仅作为预测生物标志物，而且作为治疗靶点的潜力。这些见解强调了NT-proBNP在房颤早期干预和管理策略中的潜在作用，表明未来的研究在评估房颤风险时应纳入更多变量，如生活方式因素和遗传易感性。
