Forecasting Atrial Fibrillation: The Predictive Power of N-terminal Prohormone of Brain Natriuretic Peptide in a Five-Year Study

Fawad Akbar; Deepak Lal; Muhammad Arshad; Maryum Imran; Muhammad Haidar Zaman; Sauda Usmani; Moazama Shakeel Ahmed; Fahad R Khan

doi:10.7759/cureus.62515

Forecasting Atrial Fibrillation: The Predictive Power of N-terminal Prohormone of Brain Natriuretic Peptide in a Five-Year Study

Cureus. 2024 Jun 17;16(6):e62515. doi: 10.7759/cureus.62515. eCollection 2024 Jun.

Authors

Fawad Akbar¹, Deepak Lal², Muhammad Arshad³, Maryum Imran⁴, Muhammad Haidar Zaman^{5

4}, Sauda Usmani⁶, Moazama Shakeel Ahmed⁷, Fahad R Khan⁸

Affiliations

¹ Cardiology, Tehsil Headquarter (THQ) Tangi, Government of Khyber Pakhtunkhwa, Peshawar, PAK.
² Cardiology, National Institute of Cardiovascular Heart Disease, Karachi, PAK.
³ Biochemistry, King Abdullah Teaching Hospital, Mansehra, PAK.
⁴ Health and Biological Sciences, Abasyn University, Peshawar, PAK.
⁵ Immunology, Nanjing Medical University, Nanjing, CHN.
⁶ Physiology, Pak Red Crescent Medical and Dental College, Lahore, PAK.
⁷ Internal Medicine, Mayo Hospital Lahore, Lahore, PAK.
⁸ Cardiology, Lady Reading Hospital, Peshawar, PAK.

Abstract

Introduction Atrial fibrillation (AF) is a major global health concern, and early prediction is essential for managing high-risk individuals. N-terminal prohormone of brain natriuretic peptide (NT-proBNP) has emerged as a crucial biomarker for predicting AF. While most studies have concentrated on cohorts already diagnosed with AF or other cardiac diseases, this research investigates the predictive value of NT-proBNP for AF development in a population without prior AF diagnosis. Methods and materials A five-year prospective observational study was conducted on 4090 individuals aged 45 to 75 with no previous diagnosis of AF. Baseline demographic characteristics, comorbid conditions, cardiac-specific measures, and NT-proBNP levels were systematically recorded. The primary endpoint was the onset of AF, confirmed through annual 12-lead ECG or 24-hour Holter monitoring. Univariate and multivariate analyses identified factors associated with AF onset. Results Out of the total population, 16.6% (679 individuals) developed AF. Notably, increased NT-proBNP levels (P=0.001), older age (P=0.001), and hypertension (P=0.001) were significantly associated with the onset of AF. The mean NT-proBNP levels in the AF group were significantly higher than in the non-AF group (P<0.001). The AF group also showed a higher mean age and a greater prevalence of hypertension (P<0.001 for both). Conclusion This study confirms the predictive value of NT-proBNP for AF onset in a non-AF population, highlighting older age and hypertension as significant risk factors for AF development. The findings underscore the potential of NT-proBNP not only as a predictive biomarker but also as a therapeutic target. These insights emphasize the potential role of NT-proBNP in early intervention and management strategies for AF, suggesting that future research should include additional variables, such as lifestyle factors and genetic predisposition, in assessing AF risk.

Keywords: atrial fibrillation prediction; early detection of atrial fibrillation; heart disease prevention; nt-probnp; nt-probnp and cardiac prognosis.