Atrial fibrillation risk identified early by NT-proBNP

Recent research shows that NT-proBNP levels are strongly associated with an increased risk of afib (atrial fibrillation).

N-terminal pro–B-type natriuretic peptide (NT-proBNP, also a key biomarker for diagnosing heart failure), easily included in a routine blood test, when elevated shows a nearly fourfold increase in risk for atrial fibrillation in at-risk populations.

N-terminal pro-B-type natriuretic peptide (NT-proBNP) is commonly used in clinical practice to detect abnormalities in cardiac function, especially heart failure. A systematic review recently published in the journal Heart (the international peer reviewed cardiology journal, the the flagship of BMJ's cardiology portfolio and an official journal of the British Cardiovascular Society) showed that NT-proBNP serum testing can be used to detect risk for afib (atrial fibrillation).

The authors note:

“N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a well-established biomarker in clinical practice…This meta-analysis aimed to evaluate the association between NT-proBNP levels and AF incidence, and to explore the potential of NT-proBNP in enhancing AF risk prediction models.”

Their analysis of searched databases (PubMed, Embase, Cochrane Library, Web of Science and Scopus) up to August 2024 included 136,089 participants from 16 cohorts, with 8017 incident AF cases, showed a strong relationship:

“Elevated NT-proBNP levels were associated with a higher risk of developing AF... A significant non-linear dose-response relationship was observed, and stronger associations were noted in older populations and when serum samples were used.”

The risk increased by 9% for each 10 pg/mL increase in NT-proBNP.

The study had documented limitations, but the authors conclude:

“NT-proBNP levels are strongly associated with an increased risk of AF, particularly in older adults. Incorporating NT-proBNP into risk prediction models may enhance early identification of individuals at risk of AF, with potential implications for population-based screening…”