title: Short-term fluctuations of plasma NT-proBNP levels in patients with new-onset atrial fibrillation: a way to assess time of onset?
abstract: OBJECTIVE
  The objective of this study was to characterise short-term kinetics of plasma amino-terminal pro-B natriuretic peptide (NT-proBNP) levels in patients with new-onset atrial fibrillation (AF) without heart failure.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Emergency departments and inpatient services of three large community hospitals.
  
  
  METHODS
  31 consecutive patients with new-onset atrial fibrillation (<24 h before presentation) persisting at least 48 h, without evidence of heart failure.
  
  
  METHODS
  Plasma NT-proBNP levels were obtained at presentation and then 6, 12, 18, and 24 h after presentation. A final sample was obtained 48 h after onset of AF.
  
  
  RESULTS
  Mean plasma NT-proBNP levels and 95% CIs (pg/ml) during the 48-h period following onset of AF were: 0-6 h: 636 (395 to 928), 6-12 h: 1364 (951 to 1778), 12-18 h: 1747 (1412 to 2083), 18-24 h: 1901 (1549 to 2253), 24-36 h: 1744 (1423 to 2066) and 36-48 h: 1101 (829 to 1373). Mean time to peak NT-proBNP levels was 16.7 (0.7) h; 29 patients reached their peak levels within 24 h. The mean peak NT-proBNP level was significantly higher than those obtained at 0-6 h and at 36-48 h after onset of AF (p<0.001 for both). There was no correlation between ventricular rate and plasma NT-proBNP levels during any time period after onset of AF.
  
  
  CONCLUSIONS
  In patients with new-onset AF but no clinical or radiographic evidence of heart failure, plasma NT-proBNP levels rise progressively to a peak during the first 24 h and then rapidly fall. This pattern may serve as an aid to assess the time from AF onset.
authors.affiliation: Department of Cardiology, Athens General Hospital G. Gennimatas, Athens, Greece.
authors.forename: S
authors.initials: S
authors.lastname: Deftereos
authors.forename: G
authors.initials: G
authors.lastname: Giannopoulos
authors.forename: C
authors.initials: C
authors.lastname: Kossyvakis
authors.forename: K
authors.initials: K
authors.lastname: Raisakis
authors.forename: A
authors.initials: A
authors.lastname: Theodorakis
authors.forename: A
authors.initials: A
authors.lastname: Kaoukis
authors.forename: K
authors.initials: K
authors.lastname: Toli
authors.forename: V
authors.initials: V
authors.lastname: Panagopoulou
authors.forename: M
authors.initials: M
authors.lastname: Driva
authors.forename: I
authors.initials: I
authors.lastname: Mantas
authors.forename: V
authors.initials: V
authors.lastname: Pyrgakis
authors.forename: M A
authors.initials: MA
authors.lastname: Alpert
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D013997:Time Factors
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain