Baseline NT-ProBNP level predicts success of cardioversion of atrial fibrillation with flecainide

Apelin: A novel prognostic predictor for atrial fibrillation recurrence after pulmonary vein isolation

Apelin, the ligand for the APJ receptor, is involved in the pathogenesis of atrial fibrillation (AF). However, whether serum apelin can predict the recurrence of AF after pulmonary vein isolation (PVI) has not been determined.A prospective cohort study was performed in patients with AF (but without structural heart disease) who were undergoing first-time PVI. Serum apelin-12 was measured by enzyme-linked immunosorbent assay. Echocardiographic examination was performed at baseline, 3 months, and 6 months after PVI. Patients were followed up for 6 months after PVI, and the association between baseline apelin-12 and AF recurrence (early recurrence: within 3 months after ablation; late recurrence: 3-6 months after ablation) was analyzed.A total of 61 patients were included in the study. Baseline serum level of apelin-12 was significant lower in patients with early (median [interquartile range]: 1844 [1607-2061] vs 2197 [1895-2455] ng/L, P = .01) and late (1639 [1524-1853] vs 1923 [1741-2303] ng/L, P = .02) AF recurrence compared with patients without these events. Results of Cox stepwise multivariate analysis demonstrated that lower baseline apelin-12 (<2265 ng/L) was independently associated with increased AF recurrence within 6 months after PVI (P < .05). The specificity and positive predictive value of apelin-12 for AF recurrence were significantly higher than those of baseline N-terminal brain proBNP (60.4% vs 28.6%, P < .001; 58.8% vs 34.4%, P = .01), although the sensitivity and negative predictive value were similar.Reduced baseline serum apelin-12 may be an independent risk factor for the recurrence of AF after PVI in patients without structural heart disease.

Levels of Plasma N-terminal Pro-brain Natriuretic Peptide and D-dimer on the Prognosis of Patients with Acute Cerebral Infarction

Objective

To investigate the effects of levels of D-dimer and N-terminal pro-brain natriuretic peptide (NT-pro BNP) on the prognosis of patients with acute cerebral infarction.

Methods

One hundred and twenty-four patients with acute cerebral infarction who were admitted to the hospital between July 2014 and July 2016 were selected as the observation group; 100 normal people who had health examination in the center of physical examination of our hospital were selected as the control group. The levels of D-dimer and NT-pro BNP of the two groups were observed; the correlation between the levels of plasma NT-pro BNP and D-dimer and area of cerebral infarction, complications and death condition of the observation group was investigated.

Results

The levels of D-dimer and NT-pro BNP of the observation group were much higher than those of the control group, and the difference was statistically significant (P<0.05). The levels of D-dimer and NT-pro BNP of the observation group were significantly higher than those of the control group, and the difference had statistical significance (P<0.05). The levels of plasma NT-pro BNP and D-dimer of the patients with disturbance of consciousness and high blood pressure were apparently higher than those with no disturbance of consciousness and normal blood pressure, and there was a statistically significant difference (P<0.05). The patients were followed up for half a year. The levels of D-dimer and NT-pro BNP of the dead patients were much higher than those of the survived patients on admission.

Conclusion

The levels of plasma NT-pro BNP and D-dimer can reflect the disease condition and prognosis of patients with acute cerebral infarction. Higher levels of NT-pro BNP and D-dimer indicates poorer prognosis. This work can provide a guidance for the clinical treatment of acute cerebral infarction.