title: N-terminal pro-B-type natriuretic peptide as a predictor of incident atrial fibrillation in the Multi-Ethnic Study of Atherosclerosis: the effects of age, sex and ethnicity.
abstract: OBJECTIVE
  Atrial fibrillation (AF) is a common source of medical costs, morbidity and mortality. NT pro-brain natriuretic peptide (BNP) is a remarkably strong predictor of AF in older whites; we aimed to assess if this biomarker was as predictive in other racial groups.
  
  
  METHODS
  We used covariate-adjusted Cox model regressions to estimate the HRs of developing AF as a function of NT proBNP, and tested for interactions of NT proBNP with age, gender and race/ethnicity.
  
  
  METHODS
  The Multi-Ethnic Study of Atherosclerosis (MESA).
  
  
  METHODS
  5518 subjects were followed over a median of 7.6 years. During this time, 267 developed AF.
  
  
  RESULTS
  NT proBNP was statistically significantly associated with incident AF; for ln NT proBNP, the adjusted HR was 2.2 (95% CI 1.9 to 2.5). Assessed by quintiles, the relationship between NT proBNP was strong and graded; the unadjusted HR for the highest quintile of NT proBNP was 23.7 (95% CI 11.1 to 50.6) and adjusted was 11.4 (95% CI 5.1 to 25.3). NT proBNP was an excellent predictor of incident AF in the younger and older age groups, in men and women and in the different race/ethnicity groups: the HR for ln NT proBNP as a predictor of incident AF ranged from 2.0 to 3.9 in each subgroup.
  
  
  CONCLUSIONS
  NT proBNP is a robust predictor of incident AF; its prognostic value is more significant in younger patients and women compared with older patients and men. NT proBNP was also as strongly predictive in black patients, Hispanics and Asian/Chinese as in white patients despite a lower incidence of arrhythmia.
authors.affiliation: Division of Cardiology, University of Washington, , Seattle, Washington, USA.
authors.forename: Kristen K
authors.initials: KK
authors.lastname: Patton
authors.forename: Susan R
authors.initials: SR
authors.lastname: Heckbert
authors.forename: Alvaro
authors.initials: A
authors.lastname: Alonso
authors.forename: Hossein
authors.initials: H
authors.lastname: Bahrami
authors.forename: Joao A C
authors.initials: JA
authors.lastname: Lima
authors.forename: Gregory
authors.initials: G
authors.lastname: Burke
authors.forename: Richard A
authors.initials: RA
authors.lastname: Kronmal
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000097:blood / Q000150:complications / Q000208:ethnology*; D001281:Atrial Fibrillation / Q000097:blood / Q000208:ethnology* / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D011498:Protein Precursors; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain