American Heart Association

atrial fibrillation

NT-proBNP Levels Less Predictive in HFpEF with Atrial Fibrillation

Contributors: Ike Chinyere and Michela Brambatti

N-Terminal Pro-B-Type Natriuretic Peptide Levels for Risk Prediction in Patients With Heart Failure and Preserved Ejection Fraction According to Atrial Fibrillation Status

Study Link: N-Terminal Pro-B-Type Natriuretic Peptide Levels for Risk Prediction in Patients With Heart Failure and Preserved Ejection Fraction According to Atrial Fibrillation Status

Bonus! Waveform

NT-proBNP is more predictive of unfavorable outcomes in HFpEF in the absence of AFib

Contributor: Martin Chacon

Does an increased NT-proBNP in patients with atrial fibrillation (AF) and HFpEF correspond to a higher risk for worse outcomes? Kristensen et al suggest increased NTproBNP levels do not show the same correlation with poor outcomes in patients with AF compared with those without AF. NT-proBNP is increased in AF patients independently from heart failure, therefore, its capacity to predict cardiovascular death or hospitalizations in HFpEF may be diminished.

Not necessary to adjust NT-proBNP thresholds for HFrEF patients with atrial fibrillation

Contributor: Chris Sobowale

Heart failure patients with HFrEF and atrial fibrillation (HFrEF-AF) have higher NT-proBNP than HFrEF patients without atrial fibrillation (AF). This is thought to be a consequence of AF and not necessarily correlated with deleterious clinical outcomes.

HF clinical trials have stipulated different inclusion NT-proBNP levels for patients with HFrEF-AF. It turns out, a defined higher NT-proBNP level for patients with HFpEF-AF may not be necessary.