title: NT-proBNP, but not ANP and C-reactive protein, is predictive of paroxysmal atrial fibrillation in patients undergoing pulmonary vein isolation.
abstract: OBJECTIVE
  The purpose of this study is to evaluate the relationship between plasma high-sensitivity C-reactive protein (hs-CRP), atrial natriuretic peptides (ANP), N-terminal-pro-brain natriuretic peptide (NT-proBNP) levels, and the risk and recurrence of atrial fibrillation (AF) after pulmonary vein isolation (PVI) in patients with paroxysmal atrial fibrillation (PAF).
  
  
  METHODS
  Plasma ANP, NT-proBNP, and hs-CRP levels were measured before and 3 months after PVI in 33 patients with PAF and 30 control participants.
  
  
  RESULTS
  (1) NT-proBNP levels at baseline were significantly elevated in subjects with PAF compared with control subjects (296.8 ± 272.1 vs. 80.8 ± 69.1 pg/ml), but ANP and hs-CRP levels were normal; NT-proBNP levels normalized 3 months after PVI, but ANP and hs-CRP levels did not change significantly; NT-proBNP levels at baseline in the recurrent group were markedly higher than those in the nonrecurrent AF group (572.7 ± 234.2 vs. 176.8 ± 188.7 pg/ml). (2) Cox stepwise multivariate analysis demonstrated that only elevated NT-proBNP level at baseline was an independent predictor of AF recurrence (p < 0.001) after PVI among 13 variables, such as echocardiographic parameters, plasma ANP, NT-proBNP, and hs-CRP levels. A cutoff value of NT-proBNP ≥ 423.2 pg/ml was a significant risk factor for AF recurrence (p = 0.002).
  
  
  CONCLUSIONS
  Elevated NT-proBNP level at baseline, but not ANP and hs-CRP, is a sensitive biomarker for early predicting AF recurrence in patients with PAF.
authors.affiliation: Department of Cardiology, Chongqing Cardiac Arrhythmia Therapeutic Service Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.
authors.forename: Jinqi
authors.initials: J
authors.lastname: Fan
authors.forename: Hua
authors.initials: H
authors.lastname: Cao
authors.forename: Li
authors.initials: L
authors.lastname: Su
authors.forename: Zhiyu
authors.initials: Z
authors.lastname: Ling
authors.forename: Zengzhang
authors.initials: Z
authors.lastname: Liu
authors.forename: Xianbin
authors.initials: X
authors.lastname: Lan
authors.forename: Yanping
authors.initials: Y
authors.lastname: Xu
authors.forename: Weijie
authors.initials: W
authors.lastname: Chen
authors.forename: Yuehui
authors.initials: Y
authors.lastname: Yin
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000601:surgery; D009320:Atrial Natriuretic Factor / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011667:Pulmonary Veins / Q000601:surgery*; D012008:Recurrence
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor; D002097:C-Reactive Protein