B-type natriuretic peptide predicts new-onset atrial fibrillation in patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention

The predictive value of B-type natriuretic peptide (BNP) with respect to the occurrence of new-onset atrial fibrillation (AF) in patients with ST-segment elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (PCI) is unknown. The aim of this study was to evaluate whether BNP has a predictive value for the occurrence of new-onset AF in patients with STEMI treated by primary PCI. In 180 patients with STEMI treated by primary PCI, BNP concentrations were measured 24 h after chest pain onset. The Receiver Operating Characteristic analysis was performed to identify the most useful BNP cut-off level for the prediction of AF. The patients were divided into the two groups according to calculated cut-off level: high BNP group (BNP >= 720 pg/mL, n = 33) and low BNP group (BNP <720 pg/mL, n = 147). The incidence of AF was 5.0%, and occurred more frequently in high BNP group (7/33, 21.2%) than in low BNP group (2/147, 1.4%), (p < 0.001). Patients with high BNP were older (p = 0.017), had more often anterior wall infarction (p = 0.015), higher Killip class on admission (p = 0.038), higher peak troponin I (p = 0.002), lower left ventricular ejection fraction (p = 0.029) than patients with low BNP. After multivariate adjustment, BNP was an independent predictor of AF(OR 3.70, 95% CI 1.40-9.77,p = 0.008). BNP independently predicts the occurrence of new-onset AF in STEMI patients treated by primary PCI. (C) 2012 Elsevier Inc. All rights reserved.