Baseline NT-ProBNP level predicts success of cardioversion of atrial fibrillation with flecainide

Amin, Ahmad S.; Peters, R. H. J.; Verstraaten, Maaike; Wilde, Arthur A.M.; Buijs, Eugène M.

doi:10.1007/s12471-015-0659-8

Cited by 4 publications

(3 citation statements)

References 28 publications

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“…NT-proBNP is a natriuretic hormone which, in the absence of heart failure, is secreted from the atrium in response to atrial distension and overload. [ 35 – 37 ] Consistent with the previous findings, [ 38 – 40 ] we showed that an increased plasma NT-proBNP level predicted a higher risk for AF recurrence post-PVI. Previous studies have demonstrated that BNP inhibited the resting sympathetic activity of the heart, thereby potentiating vagal activity through activating the cGMP pathway and inciting atrial overload and atrial remodeling, which results in sustaining atrial fibrillatory rotors and potentially initiating and sustaining AF.…”

Section: Discussionsupporting

confidence: 91%

Apelin

Wang¹,

Fan

Zhong³

et al. 2018

Medicine

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Apelin, the ligand for the APJ receptor, is involved in the pathogenesis of atrial fibrillation (AF). However, whether serum apelin can predict the recurrence of AF after pulmonary vein isolation (PVI) has not been determined.A prospective cohort study was performed in patients with AF (but without structural heart disease) who were undergoing first-time PVI. Serum apelin-12 was measured by enzyme-linked immunosorbent assay. Echocardiographic examination was performed at baseline, 3 months, and 6 months after PVI. Patients were followed up for 6 months after PVI, and the association between baseline apelin-12 and AF recurrence (early recurrence: within 3 months after ablation; late recurrence: 3–6 months after ablation) was analyzed.A total of 61 patients were included in the study. Baseline serum level of apelin-12 was significant lower in patients with early (median [interquartile range]: 1844 [1607–2061] vs 2197 [1895–2455] ng/L, P = .01) and late (1639 [1524–1853] vs 1923 [1741–2303] ng/L, P = .02) AF recurrence compared with patients without these events. Results of Cox stepwise multivariate analysis demonstrated that lower baseline apelin-12 (<2265 ng/L) was independently associated with increased AF recurrence within 6 months after PVI (P < .05). The specificity and positive predictive value of apelin-12 for AF recurrence were significantly higher than those of baseline N-terminal brain proBNP (60.4% vs 28.6%, P < .001; 58.8% vs 34.4%, P = .01), although the sensitivity and negative predictive value were similar.Reduced baseline serum apelin-12 may be an independent risk factor for the recurrence of AF after PVI in patients without structural heart disease.

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Section: Discussionsupporting

confidence: 91%

Apelin

Wang¹,

Fan

Zhong³

et al. 2018

Medicine

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“…In 17 of the 58 articles (29%), we noted discrepancies with AF guidelines, specifically regarding the PCV drug used, the patients' comorbidities and the PCV contraindications (Table 4). 16,18,[20][21][22][26][27][28]31,32,36,39,41,49,55,60,63 According to the data presented in the articles, it appeared that a total of 239 patients underwent PCV using a drug that was contraindicated given their specific comorbidities. In the described cases, the most common culprit PCV drug was ibutilide, followed by vernakalant, amiodarone, propafenone, and flecainide.…”

Section: Resultsmentioning

confidence: 99%

Does the choice of drug in pharmacologic cardioversion correlate with the guidelines? Systematic review

Springer¹,

Szmuda²,

Kozłowski³

2021

Adv Clin Exp Med

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Background. Atrial fibrillation (AF) is the most common sustained arrhythmia, the most common cause of supraventricular tachycardia in the global population and the most common arrhythmia requiring treatment in an emergency department. Objectives.To systematically review recent literature and quantify the correlation between the choice of pharmacological cardioversion (PCV) drug and the national or international guidelines. Materials and methods.A systematic review was performed in accordance with the PRISMA statement methodology. The PubMed search engine was used to search for articles regardless of type or language and published in the last 6 years (May 2014-May 2020). In addition, we searched for AF guidelines and recommendations published online by cardiology and emergency medicine societies.Results. The search strategy returned a total of 2615 abstracts. A total of 2598 full texts were screened; 2540 full texts were excluded with reasons and 58 articles from 32 countries were included in the analysis. In 17 of the 58 articles (29%), we noted discrepancies with the AF guidelines, specifically regarding the PCV drug used, the patients' comorbidities and the contraindications associated with the PCV drug. The most common clinical situation for the use of a contraindicated drug was when ibutilide was administered to patients with heart failure. The analysis did not reveal any statistically significant correlations, although the correlation between the sample size and guideline adherence was close to statistical significance (p < 0.06). Conclusions.Our systematic analysis revealed substantial non-adherence to AF treatment guidelines.

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“…NT-pro BNP, a fractured fragment of BNP, is featured by long half-life period and easy detection compared to BNP. 11 Studies have found that NT-pro BNP has important significance in cerebrovascular diseases. 12 , 13 In this study, the level of NT-pro BNP of the observation group was significantly higher than that of the control group, which was consistent with the results of the current studies.…”

Section: Discussionmentioning

confidence: 99%

Levels of Plasma N-terminal Pro-brain Natriuretic Peptide and D‑dimer on the Prognosis of Patients with Acute Cerebral Infarction

2018

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Objective:To investigate the effects of levels of D-dimer and N-terminal pro-brain natriuretic peptide (NT-pro BNP) on the prognosis of patients with acute cerebral infarction.Methods:One hundred and twenty-four patients with acute cerebral infarction who were admitted to the hospital between July 2014 and July 2016 were selected as the observation group; 100 normal people who had health examination in the center of physical examination of our hospital were selected as the control group. The levels of D-dimer and NT-pro BNP of the two groups were observed; the correlation between the levels of plasma NT-pro BNP and D-dimer and area of cerebral infarction, complications and death condition of the observation group was investigated.Results:The levels of D-dimer and NT-pro BNP of the observation group were much higher than those of the control group, and the difference was statistically significant (P<0.05). The levels of D-dimer and NT-pro BNP of the observation group were significantly higher than those of the control group, and the difference had statistical significance (P<0.05). The levels of plasma NT-pro BNP and D-dimer of the patients with disturbance of consciousness and high blood pressure were apparently higher than those with no disturbance of consciousness and normal blood pressure, and there was a statistically significant difference (P<0.05). The patients were followed up for half a year. The levels of D-dimer and NT-pro BNP of the dead patients were much higher than those of the survived patients on admission.Conclusion:The levels of plasma NT-pro BNP and D-dimer can reflect the disease condition and prognosis of patients with acute cerebral infarction. Higher levels of NT-pro BNP and D-dimer indicates poorer prognosis. This work can provide a guidance for the clinical treatment of acute cerebral infarction.

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Baseline NT-ProBNP level predicts success of cardioversion of atrial fibrillation with flecainide

Cited by 4 publications

References 28 publications

Apelin

Apelin

Does the choice of drug in pharmacologic cardioversion correlate with the guidelines? Systematic review

Levels of Plasma N-terminal Pro-brain Natriuretic Peptide and D‑dimer on the Prognosis of Patients with Acute Cerebral Infarction

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