title: Relation of N-terminal pro-brain natriuretic peptide and new-onset atrial fibrillation in patients with acute coronary syndrome: a systematic review and meta-analysis.
abstract: BACKGROUND
  Several observational studies evaluated the associations of baseline N-terminal pro-brain natriuretic peptide (NT-proBNP) and new-onset atrial fibrillation (AF) in patients with acute coronary syndrome (ACS), but the results were contradictory.
  
  
  METHODS
  Electronic bibliographic databases were searched from inception to May 2015, and the results reviewed by two independent reviewers. Pooled standardized mean difference (SMD) and 95% confidence interval (CI) were calculated to assess associations between NT-proBNP levels and new-onset AF in patients with ACS. We performed sensitivity analyses to explore the potential sources of heterogeneity and estimated publication biases.
  
  
  RESULTS
  Six papers, including 5861 patients (438 with AF and 5423 without AF) with ACS were analyzed. Overall, the NT-proBNP levels were higher in patients with new-onset AF than controls without AF. The SMD of the NT-proBNP levels between the patients with and those without AF was 0.53 units (95% CI 0.37-0.70), test for overall effect z-score =6.30 (p < 0.00001). The heterogeneity test showed that there were moderate differences between individual studies (p = 0.02; I(2) =( )62%). Further analysis revealed that differences of ethnic groups and the sample size of studies possibly account for this heterogeneity.
  
  
  CONCLUSIONS
  In spite of moderate heterogeneity across the enrolled studies, our meta-analysis suggests that increased NT-proBNP levels are associated with greater risk of new-onset AF with ACS, which indicates that NT-proBNP levels may be a useful biomarker in predicting new-onset AF in patients with ACS.
authors.affiliation: a Division of Chest Pain Center , Guangdong Provincial Hospital of Chinese Medicine & the 2nd Clinical College of Guangzhou University of Chinese Medicine , Guangzhou , 510120 , China.
authors.forename: Xiongyi
authors.initials: X
authors.lastname: Gao
authors.affiliation: a Division of Chest Pain Center , Guangdong Provincial Hospital of Chinese Medicine & the 2nd Clinical College of Guangzhou University of Chinese Medicine , Guangzhou , 510120 , China.
authors.forename: Ruixiang
authors.initials: R
authors.lastname: Zeng
authors.affiliation: a Division of Chest Pain Center , Guangdong Provincial Hospital of Chinese Medicine & the 2nd Clinical College of Guangzhou University of Chinese Medicine , Guangzhou , 510120 , China.
authors.forename: Pengda
authors.initials: P
authors.lastname: Liao
authors.affiliation: a Division of Chest Pain Center , Guangdong Provincial Hospital of Chinese Medicine & the 2nd Clinical College of Guangzhou University of Chinese Medicine , Guangzhou , 510120 , China.
authors.forename: Huizheng
authors.initials: H
authors.lastname: Zhu
authors.affiliation: a Division of Chest Pain Center , Guangdong Provincial Hospital of Chinese Medicine & the 2nd Clinical College of Guangzhou University of Chinese Medicine , Guangzhou , 510120 , China.
authors.forename: Minzhou
authors.initials: M
authors.lastname: Zhang
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D001281:Atrial Fibrillation / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012306:Risk
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Acute coronary syndrome; N-terminal pro-brain natriuretic peptide; atrial fibrillation