SERUM cardiac-specific biomarkers and atrial fibrillation in myotonic dystrophy type I

J Cardiovasc Electrophysiol. 2019 Dec;30(12):2914-2919. doi: 10.1111/jce.14211. Epub 2019 Oct 9.

Abstract

Introduction: The aim of the present study was to evaluate the role of high-sensitivity cardiac troponin I, N terminal pro-B-type natriuretic peptide (NT-proBNP), creatine kinase-MB mass concentration (CK-MB mass) and copeptin (CP) in predicting incident atrial fibrillation (AF) in myotonic dystrophy type 1 (DM1) patients.

Materials and methods: The study enrolled 60 consecutive DM1 patients (age 50.3 ± 7.3 years, 34 male) who underwent pacemaker (PM) implantation for cardiac rhythm abnormalities and 60 PM recipients whose age and sex matched served as control group. All DM1 patients underwent a 12-lead electrocardiogram, 2D color Doppler echocardiogram, biomarkers measurements and device interrogation at implantation, 1 month after and every 6 months thereafter for a minimum of 2-year follow-up.

Results: The study population was divided into two groups according to the presence of AF (AF group vs non-AF group). The AF group was older (47.3 ± 8 vs 38.6 ± 7 years, P = .03) and showed higher serum levels of NT-proBNP (151 ± 38.4 vs 107.3 ± 24.2 pg/mL, P < .001) and CP (18.9 ± 4.5 vs 7 ± 2.3 P < .001) than non-AF Group. NT-proBNP (P < .001) and CP (P < .001) were found to be an independent predictor of AF. Based on the receiver-operating characteristics curve analysis, the cut-off value for NT-proBNP that best predicted AF event in DM1 patients was 123 pg/ml (sensitivity of 83.3% and specificity of 86.5%); the cut-off value for CP that best predicted AF event in DM1 patients was 9 pmol/L (sensitivity of 89% and specificity of 87%).

Conclusion: NT-proBNP and CP represent two independent predictors of AF onset in DM1 population with conduction disturbances underwent PM implantation.

Keywords: N terminal pro-B-type natriuretic peptide; atrial fibrillation; biomarkers; copeptin; creatine kinase-MB mass.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Atrial Fibrillation / blood*
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / epidemiology
  • Biomarkers / blood
  • Case-Control Studies
  • Creatine Kinase, MB Form / blood
  • Female
  • Glycopeptides / blood*
  • Humans
  • Incidence
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Myotonic Dystrophy / blood*
  • Myotonic Dystrophy / diagnosis
  • Myotonic Dystrophy / epidemiology
  • Natriuretic Peptide, Brain / blood*
  • Peptide Fragments / blood*
  • Predictive Value of Tests
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Troponin I / blood

Substances

  • Biomarkers
  • Glycopeptides
  • Peptide Fragments
  • Troponin I
  • copeptins
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain
  • Creatine Kinase, MB Form