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MR-proANP measured at admission is associated with incident atrial fibrillation in STEMI patients

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Abstract

Atrial fibrillation (AF) is common following ST-segment elevation myocardial infarction (STEMI). Increased blood levels of mid regional pro atrial natriuretic peptide (MR-proANP) have been associated with a greater risk of incident AF. However, knowledge of the value of MR-proANP in predicting incident AF after STEMI is sparse. To assess whether MR-proANP measured at admission is associated with development of incident AF in patients with STEMI. 673 STEMI patients with no history of AF treated with primary percutaneous coronary intervention (pPCI) were prospectively enrolled from September 2006 to December 2008. Blood samples were drawn before the procedure. MR-proANP was measured by an automated processing assay. End point was incident AF. Median follow-up time was 5.5 years (interquartile-range 4.7–6.0), during which 63 patients developed AF. In a multivariable Cox regression model adjusted for relevant clinical and biochemical variables, MR-proANP was significantly associated with the development of AF (HR 1.18 per 100 pmol, 95% CI 1.11–1.28, p < 0.001). In a subgroup of patients who underwent echocardiography (N = 360), MR-proANP remained significantly associated with the development of AF (HR 1.39 per 100 pmol, 95% CI 1.13–1.71, p = 0.002) after adjusting for clinical and biochemical variables and left ventricular ejection fraction. When stratifying patients according to tertiles of MR-proANP, patients in the upper tertile displayed an 11 times greater risk of developing AF during follow-up as compared to patients in the lower tertile (HR 11.1, 95% CI 4.4–28.2, p < 0.001). Plasma MR-proANP measured at admission is an independent predictor of incident AF after STEMI.

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Authors and Affiliations

  1. Cardiovascular Non-Invasive Imaging Research Laboratory, Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Hospitalsvej 8, post 835, 2900, Copenhagen, Denmark

    Alma Wegener, Daniel Modin, Sune Pedersen, Søren Lindberg, Kasper Iversen, Gunnar Gislason & Tor Biering-Sørensen

  2. Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark

    Kasper Iversen, Gunnar Gislason & Tor Biering-Sørensen

  3. Department of Biomedical Science, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark

    Thomas Jespersen

  4. Department of Cardiology and Clinical Research, Nordsjællands Hospital, Hillerød, Denmark

    Manan Pareek

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  1. Alma Wegener
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Wegener, A., Modin, D., Pedersen, S. et al. MR-proANP measured at admission is associated with incident atrial fibrillation in STEMI patients. Heart Vessels 37, 1906–1913 (2022). https://doi.org/10.1007/s00380-022-02099-8

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  • DOI: https://doi.org/10.1007/s00380-022-02099-8

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