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Yuan Y, Nie B, Gao B, Guo C, Li L. Natriuretic peptides as predictors for atrial fibrillation recurrence after catheter ablation: A meta-analysis. Medicine (Baltimore) 2023; 102:e33704. [PMID: 37171306 PMCID: PMC10174372 DOI: 10.1097/md.0000000000033704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Catheter ablation (CA) has become the first-line treatment strategy for atrial fibrillation (AF) but remains with a substantial recurrence rate. The aim of this meta-analysis was to determine the association between baseline natriuretic peptide levels and AF recurrence after CA. METHODS We systematically searched PubMed, EMBASE, Web of Science, and Wiley-Cochrane Library for relevant studies published up until May 2022. Overall effect analysis and subgroup analysis were performed with Review Manager software. RESULTS Finally, 61 studies that met the inclusion criteria were included in our meta-analysis. Compared with the nonrecurrence group, the recurrence group had increased baseline level of atrial natriuretic peptide (ANP) (standardized mean difference [SMD] = 0.39, 95% confidence interval [CI]: 0.21-0.56), brain natriuretic peptide (BNP) (SMD = 0.51, 95% CI: 0.31-0.71), N-terminal pro-BNP (SMD = 0.71, 95% CI: 0.49-0.92), and midregional N-terminal pro-ANP (SMD = 0.91, 95% CI: 0.27-1.56). CONCLUSIONS Increased baseline natriuretic peptide levels, including ANP, BNP, N-terminal pro-BNP, and midregional N-terminal pro-ANP, are associated with a higher risk of AF recurrence after CA. Nonetheless, further studies are needed to elucidate the predictive value of baseline natriuretic peptides in AF patients undergoing CA.
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Affiliation(s)
- Yujing Yuan
- Department of Cardiology, Shanxi Cardiovascular Hospital, Taiyuan, Shanxi, People's Republic of China
| | - Boyuan Nie
- Department of Day Surgery, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Binbin Gao
- Department of Cardiology, Shanxi Cardiovascular Hospital, Taiyuan, Shanxi, People's Republic of China
| | - Caixia Guo
- Department of Cardiology, Shanxi Cardiovascular Hospital, Taiyuan, Shanxi, People's Republic of China
| | - Li Li
- Department of Cardiology, Shanxi Cardiovascular Hospital, Taiyuan, Shanxi, People's Republic of China
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Meijers WC, Bayes-Genis A, Mebazaa A, Bauersachs J, Cleland JGF, Coats AJS, Januzzi JL, Maisel AS, McDonald K, Mueller T, Richards AM, Seferovic P, Mueller C, de Boer RA. Circulating heart failure biomarkers beyond natriuretic peptides: review from the Biomarker Study Group of the Heart Failure Association (HFA), European Society of Cardiology (ESC). Eur J Heart Fail 2021; 23:1610-1632. [PMID: 34498368 PMCID: PMC9292239 DOI: 10.1002/ejhf.2346] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 08/13/2021] [Accepted: 09/07/2021] [Indexed: 12/18/2022] Open
Abstract
New biomarkers are being evaluated for their ability to advance the management of patients with heart failure. Despite a large pool of interesting candidate biomarkers, besides natriuretic peptides virtually none have succeeded in being applied into the clinical setting. In this review, we examine the most promising emerging candidates for clinical assessment and management of patients with heart failure. We discuss high-sensitivity cardiac troponins (Tn), procalcitonin, novel kidney markers, soluble suppression of tumorigenicity 2 (sST2), galectin-3, growth differentiation factor-15 (GDF-15), cluster of differentiation 146 (CD146), neprilysin, adrenomedullin (ADM), and also discuss proteomics and genetic-based risk scores. We focused on guidance and assistance with daily clinical care decision-making. For each biomarker, analytical considerations are discussed, as well as performance regarding diagnosis and prognosis. Furthermore, we discuss potential implementation in clinical algorithms and in ongoing clinical trials.
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Affiliation(s)
- Wouter C Meijers
- Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Antoni Bayes-Genis
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, CIBERCV, Barcelona, Spain
| | - Alexandre Mebazaa
- Inserm U942-MASCOT; Université de Paris; Department of Anesthesia and Critical Care, Hôpitaux Saint Louis & Lariboisière; FHU PROMICE, Paris, France.,Université de Paris, Paris, France.,Department of Anesthesia and Critical Care, Hôpitaux Saint Louis & Lariboisière, Paris, France.,FHU PROMICE, Paris, France
| | - Johann Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - John G F Cleland
- Robertson Centre for Biostatistics and Clinical Trials, University of Glasgow; National Heart & Lung Institute, Imperial College London, London, UK
| | - Andrew J S Coats
- Monash University, Melbourne, Australia.,University of Warwick, Coventry, UK
| | | | | | | | - Thomas Mueller
- Department of Clinical Pathology, Hospital of Bolzano, Bolzano, Italy
| | - A Mark Richards
- Christchurch Heart Institute, Christchurch, New Zealand.,Cardiovascular Research Institute, National University of Singapore, Singapore
| | - Petar Seferovic
- Faculty of Medicine, Belgrade University, Belgrade, Serbia.,Serbian Academy of Sciences and Arts, Belgarde, Serbia
| | | | - Rudolf A de Boer
- Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands
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Badoz M, Serzian G, Favoulet B, Sellal JM, De Chillou C, Hammache N, Laurent G, Mebazaa A, Ecarnot F, Bardonnet K, Seronde MF, Schiele F, Meneveau N. Impact of Midregional N-Terminal Pro-Atrial Natriuretic Peptide and Soluble Suppression of Tumorigenicity 2 Levels on Heart Rhythm in Patients Treated With Catheter Ablation for Atrial Fibrillation: The Biorhythm Study. J Am Heart Assoc 2021; 10:e020917. [PMID: 34187182 PMCID: PMC8403329 DOI: 10.1161/jaha.121.020917] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background We assessed the impact of preprocedural plasma levels of MRproANP (midregional N‐terminal pro–atrial natriuretic peptide) and sST2 (soluble suppression of tumorigenicity 2) on recurrence of atrial fibrillation (AF) at 1 year after catheter ablation of AF. Methods and Results This was a prospective, multicenter, observational study including patients undergoing catheter ablation of AF. MRproANP and sST2 were measured in a peripheral venous blood preprocedure, and MRproANP was assessed in the right and left atrial blood during ablation. The primary end point was recurrent AF between 3 and 12 months postablation, defined as a documented (>30 seconds) episode of AF, flutter, or atrial tachycardia. We included 106 patients from December 2017 to March 2019; 105 had complete follow‐up, and the mean age was 63 years with 74.2% males. Overall, 34 patients (32.1%) had recurrent AF. In peripheral venous blood, MRproANP was significantly higher in patients with recurrent AF (median, 192.2; [quartile 1–quartile 3, 155.9–263.9] versus 97.1 [60.9–150.7] pmol/L; P<0.0001), as was sST2 (median, 30.3 [quartile 1–quartile 3, 23.3–39.3] versus 23.4 [95% CI, 17.4–33.0] ng/mL; P=0.0033). In the atria, MRproANP was significantly higher than in peripheral blood and was higher during AF than during sinus rhythm. Receiver operating characteristic curve analysis identified a threshold of MRproANP>107.9 pmol/L to predict AF recurrence at 1 year and a threshold of >26.7 ng/mL for sST2. By multivariate analysis, MRproANP>107.9 pmol/L was the only independent predictor of recurrent AF (OR, 24.27; 95% CI, 4.23–139.18). MRproANP<107.9 pmol/L identified subjects at very low risk of recurrence (negative predictive value >95%). Conclusions Elevated MRproANP level independently predicts recurrent AF, whereas sST2 levels do not appear to have any prognostic value in assessing the risk of recurrence of AF up to 1 year after catheter ablation. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03351816.
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Affiliation(s)
- Marc Badoz
- Department of CardiologyUniversity Hospital Besançon Besançon France.,EA3920University of Burgundy Franche-Comté Besançon France
| | - Guillaume Serzian
- Department of CardiologyUniversity Hospital Besançon Besançon France
| | - Baptiste Favoulet
- Department of CardiologyUniversity Hospital Besançon Besançon France
| | - Jean-Marc Sellal
- Department of Cardiology Centre Hospitalier Régional Universitaire de NancyUniversité de Lorraine Nancy France.,IADIINSERM U1254Université de Lorraine Nancy France
| | - Christian De Chillou
- Department of Cardiology Centre Hospitalier Régional Universitaire de NancyUniversité de Lorraine Nancy France
| | - Néfissa Hammache
- Department of Cardiology Centre Hospitalier Régional Universitaire de NancyUniversité de Lorraine Nancy France.,IADIINSERM U1254Université de Lorraine Nancy France
| | - Gabriel Laurent
- Department of Cardiology University Hospital François Mitterand Dijon France
| | - Alexandre Mebazaa
- INSERM UMR-S 942 Paris France.,Department of Anesthesiology and Critical Care Medicine Assistance Publique - Hôpitaux de ParisSaint Louis Lariboisière University Hospitals Paris France
| | - Fiona Ecarnot
- Department of CardiologyUniversity Hospital Besançon Besançon France.,EA3920University of Burgundy Franche-Comté Besançon France
| | - Karine Bardonnet
- Department of BiochemistryUniversity Hospital Besançon Besançon France
| | - Marie-France Seronde
- Department of CardiologyUniversity Hospital Besançon Besançon France.,EA3920University of Burgundy Franche-Comté Besançon France
| | - François Schiele
- Department of CardiologyUniversity Hospital Besançon Besançon France.,EA3920University of Burgundy Franche-Comté Besançon France
| | - Nicolas Meneveau
- Department of CardiologyUniversity Hospital Besançon Besançon France.,EA3920University of Burgundy Franche-Comté Besançon France
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