Short-term fluctuations of plasma NT-proBNP levels in patients with new-onset atrial fibrillation: a way to assess time of onset?
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.
Deftereos
S
S
Department of Cardiology, Athens General Hospital G. Gennimatas, Athens, Greece.
Giannopoulos
G
G
Kossyvakis
C
C
Raisakis
K
K
Theodorakis
A
A
Kaoukis
A
A
Toli
K
K
Panagopoulou
V
V
Driva
M
M
Mantas
I
I
Pyrgakis
V
V
Alpert
M A
MA
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
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain