Natriuretic Peptides for the Detection of Paroxysmal Atrial Fibrillation in Patients with Cerebral Ischemia – the Find-AF Study 英文参考文献.docVIP

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Natriuretic Peptides for the Detection of Paroxysmal Atrial Fibrillation in Patients with Cerebral Ischemia – the Find-AF Study 英文参考文献.doc

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Natriuretic Peptides for the Detection of Paroxysmal Atrial Fibrillation in Patients with Cerebral Ischemia – the Find-AF Study 英文参考文献

NatriureticPeptidesfortheDetectionofParoxysmal AtrialFibrillationinPatientswithCerebralIschemia–the Find-AFStudy RolfWachter1*,RosineLahno1,BeatriceHaase1,MarkWeber-Kru¨ger1,JoachimSeegers1, FrankEdelmann1,JaninWohlfahrt2,Go¨tzGelbrich3,AnkeGo¨rlitz4,PawelKermer2,DirkVollmann1, GerdHasenfu?1,KlausGro¨schel5,RaoulStahrenberg1 1DepartmentofCardiologyandPneumology,UniversityofGo¨ttingen,Go¨ttingen,Germany,2DepartmentofNeurology,UniversityofGo¨ttingen,Go¨ttingen,Germany, 3CenterforClinicalTrials,UniversityofLeipzig,Leipzig,Germany,4InstituteforClinicalTrials,UniversityofGo¨ttingen,Go¨ttingen,Germany,5DepartmentofNeurology, UniversityofMainz,Mainz,Germany Abstract Background and Purpose: Diagnosis of paroxysmal atrial fibrillation (AF) can be challenging, but it is highly relevant in patientspresentingwithsinusrhythmandacutecerebralischemia.Weaimedtoevaluateprospectivelywhethernatriuretic peptidelevelsandkineticsidentifypatientswithparoxysmalAF. Methods:PatientswithacutecerebralischemiawereincludedintotheprospectiveobservationalFind-AFstudy.N-terminal pro brain-type natriuretic peptide (NT-proBNP), brain-type natriuretic peptide (BNP) and N-terminal pro atrial-type natriureticpeptide(NT-proANP)plasmalevelsweremeasuredonadmission,after6and24hours.PatientsfreefromAFat presentation received 7 day Holter monitoring. We prospectively hypothesized that patients presenting in sinus rhythm withNT-proBNP.medianweremorelikelytohaveparoxysmalAFthanpatientswithNT-proBNP,median. Results: 281 patients were included, of whom 237 (84.3%) presented in sinus rhythm. 220 patients na?¨ve to AF with an evaluableprolongedHolterECGwereanalysed.InpatientswithNT-proBNP.median(239pg/ml),17.9%hadparoxysmalAF incontrastto7.4%withNT-proBNP,239pg/ml(p=0.025).Theratioofearly(0h)tolate(24h)plasmalevelsofNT-proBNP showedno difference between both groups. For thedetection of paroxysmal atrial fibrillation, BNP, NT-proBNP andNT- proANP at admission had an area under the curve in ROC analysis of 0.747 (0