Abstract
BackgroundAtrial fibrillation (AF) is the most common arrhythmia and has increased prevalence in older patients, leading to poor prognosis for these patients. There is a need for a biomarker or a model of prognostic evaluation in older patients with AF, especially in China. CHADS2 and CHA2DS2VASc scores have been applied to evaluate their prognosis in patients with AF. This analysis was designed to examine whether N-terminal pro-brain natriuretic peptide (NT-proBNP) levels significantly improved the evaluation of all-cause mortality in older Chinese patients with AF when added to CHADS2 and CHA2DS2VASc scores.MethodsThere were 219 older patients with AF, and follow-up was 100% complete over an average of 1.11 years. Cox regression analysis was applied to determine the variables independently associated with all-cause mortality.ResultsMedian age was 85 years, and all-cause mortality was 24.2% (53 patients). Plasma NT-proBNP levels were significantly associated with all-cause mortality in univariate [hazard ratio (HR): 1.842; 95% confidence interval (CI): 1.530–2.218] and multivariate (HR: 1.377; 95% CI: 1.063–1.785) Cox regression analyses and had significantly higher c-statistic (0.771; 95% CI: 0.698–0.845) than CHADS2 (0.639; 95% CI: 0.552–0.726) and CHA2DS2VASc (0.633; 95% CI: 0.546–0.720) scores (P < 0.05 for all). The addition of NT-proBNP levels to CHADS2 (0.783; 95% CI: 0.713–0.854) and CHA2DS2VASc (0.775; 95% CI: 0.704–0.846) scores significantly increased their c-statistics (P < 0.001 for all). Model based on NT-proBNP levels including age, hemoglobin, fasting blood glucose, glomerular filtration rate and NT-proBNP levels had a significantly higher c-statistic (0.890; 95% CI: 0.841–0.938) than CHADS2 and CHA2DS2VASc scores (P < 0.001 for all). Model based on NT-proBNP levels had significantly higher c-statistic than the addition of NT-proBNP levels to CHADS2 and CHA2DS2VASc scores (P < 0.05).ConclusionNT-proBNP levels were an independent biomarker associated with an increased all-cause mortality in older Chinese patients with AF, and had an independent and added ability to evaluate their all-cause mortality compared with CHADS2 and CHA2DS2VASc scores.
Highlights
Atrial fibrillation (AF) is the most common arrhythmia and has increased prevalence in older patients, leading to poor prognosis for these patients
The aim of the current analysis was to examine whether NT-proBNP levels significantly improved the evaluation of all-cause mortality in older Chinese patients with AF when added to CHADS2 and CHA2DS2VASc scores
NT-proBNP levels were significantly associated with all-cause mortality in univariate Cox regression analysis [hazard ratio (HR): 1.84; 95% confidence interval (CI): 1.53–2.22; P < 0.001; Table 1) and had significantly higher c-statistic (0.77; 95% CI: 0.70–0.85) than CHADS2 (0.64; 95% CI: 0.55–0.73); P = 0.013) and CHA2DS2VASc (0.63; 95% CI: 0.55–0.72; P = 0.009) scores (Table 2; Fig. 1)
Summary
Atrial fibrillation (AF) is the most common arrhythmia and has increased prevalence in older patients, leading to poor prognosis for these patients. CHADS2 and CHA2DS2VASc scores have been applied to evaluate their prognosis in patients with AF This analysis was designed to examine whether N-terminal pro-brain natriuretic peptide (NT-proBNP) levels significantly improved the evaluation of all-cause mortality in older Chinese patients with AF when added to CHADS2 and CHA2DS2VASc scores. No study has assessed whether NT-proBNP levels improve prognostic evaluation of CHADS2 and CHA2DS2VASc scores, especially in older Chinese patients. Age and race can have significant effects on the prognostic evaluation of patients with AF, and further studies are needed to assess the effects of adding NT-proBNP levels to CHADS2 and CHA2DS2VASc scores on the prognostic evaluation of older Chinese patients with AF [9]. The aim of the current analysis was to examine whether NT-proBNP levels significantly improved the evaluation of all-cause mortality in older Chinese patients with AF when added to CHADS2 and CHA2DS2VASc scores
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
