title: Amino-terminal B-natriuretic peptide levels and postablation recurrence in hypertensive patients with paroxysmal atrial fibrillation.
abstract: BACKGROUND
  Amino-terminal B-type natriuretic peptide (NT-proBNP) has been shown to predict postablation recurrences of atrial fibrillation (AF); however, given the associations of natriuretic peptides with various cardiovascular parameters potentially related to AF, whether the observed association with recurrence is truly an independent one is not clear.
  
  
  OBJECTIVE
  The purpose of this analysis was to assess the association of NT-proBNP levels with AF recurrence after radiofrequency ablation.
  
  
  METHODS
  This was a post hoc analysis of a prospective study of 296 hypertensive patients with symptomatic paroxysmal AF and no history of heart failure who were scheduled to undergo pulmonary vein isolation. NT-proBNP was measured at baseline, and patients were followed for a median of 13.7 months.
  
  
  RESULTS
  NT-proBNP levels at baseline were higher in patients with recurrence (269 pg/mL [199-361 pg/mL]) vs those who remained arrhythmia-free (188 pg/mL [146-320 pg/mL], P<.001). In a univariate Cox regression model, each higher quartile of NT-proBNP corresponded to a 47% (95% confidence interval 21.5%-77.9%) increase in the risk of recurrence. However, when baseline clinical AF burden, in terms of the number of clinical AF episodes in the previous year, was added to the model, the association of NT-proBNP lost its significance (adjusted hazard ratio 1.22, 95% confidence interval 0.94-1.57).
  
  
  CONCLUSIONS
  This is the largest series to date showing that NT-proBNP is a univariate predictor of postablation AF recurrence. However, it seems that adjustment for other covariates, including the number of AF episodes within the previous year, renders this association nonsignificant.
authors.affiliation: Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece; 2nd Department of Cardiology, University of Athens Medical School, Attikon Hospital, Athens, Greece. Electronic address: ggiann@med.uoa.gr.
authors.forename: Georgios
authors.initials: G
authors.lastname: Giannopoulos
authors.affiliation: Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Kossyvakis
authors.affiliation: Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Angelidis
authors.affiliation: Department of Cardiology, "Evaggelismos" General Hospital, Athens, Greece.
authors.forename: Michael
authors.initials: M
authors.lastname: Efremidis
authors.affiliation: 1st Department of Cardiology, University of Athens Medical School, Hippokration Hospital, Athens, Greece.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Panagopoulou
authors.affiliation: Department of Cardiology, "Evaggelismos" General Hospital, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Letsas
authors.affiliation: Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Bouras
authors.affiliation: 1st Cardiology Division, AHEPA University Hospital, Medical School, University of Thessaloniki, Greece.
authors.forename: Vassilios P
authors.initials: VP
authors.lastname: Vassilikos
authors.affiliation: Division of Cardiology, University of Ioannina Medical School, Ioannina, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Goudevenos
authors.affiliation: 1st Department of Cardiology, University of Athens Medical School, Hippokration Hospital, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tousoulis
authors.affiliation: 2nd Department of Cardiology, University of Athens Medical School, Attikon Hospital, Athens, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Lekakis
authors.affiliation: Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece; 2nd Department of Cardiology, University of Athens Medical School, Attikon Hospital, Athens, Greece.
authors.forename: Spyridon
authors.initials: S
authors.lastname: Deftereos
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D015415:Biomarkers / Q000097:blood; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis; D011379:Prognosis; D016016:Proportional Hazards Models; D011667:Pulmonary Veins / Q000601:surgery*; D012008:Recurrence; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Amino-terminal fragment of brain-type natriuretic peptide; Brain-type natriuretic peptide; Pulmonary vein isolation; Radiofrequency ablation