Natriuretic peptides as predictors for atrial fibrillation recurrence after catheter ablation: A meta-analysis

Medicine (Baltimore). 2023 May 12;102(19):e33704. doi: 10.1097/MD.0000000000033704.

Abstract

Background: Catheter ablation (CA) has become the first-line treatment strategy for atrial fibrillation (AF) but remains with a substantial recurrence rate. The aim of this meta-analysis was to determine the association between baseline natriuretic peptide levels and AF recurrence after CA.

Methods: We systematically searched PubMed, EMBASE, Web of Science, and Wiley-Cochrane Library for relevant studies published up until May 2022. Overall effect analysis and subgroup analysis were performed with Review Manager software.

Results: Finally, 61 studies that met the inclusion criteria were included in our meta-analysis. Compared with the nonrecurrence group, the recurrence group had increased baseline level of atrial natriuretic peptide (ANP) (standardized mean difference [SMD] = 0.39, 95% confidence interval [CI]: 0.21-0.56), brain natriuretic peptide (BNP) (SMD = 0.51, 95% CI: 0.31-0.71), N-terminal pro-BNP (SMD = 0.71, 95% CI: 0.49-0.92), and midregional N-terminal pro-ANP (SMD = 0.91, 95% CI: 0.27-1.56).

Conclusions: Increased baseline natriuretic peptide levels, including ANP, BNP, N-terminal pro-BNP, and midregional N-terminal pro-ANP, are associated with a higher risk of AF recurrence after CA. Nonetheless, further studies are needed to elucidate the predictive value of baseline natriuretic peptides in AF patients undergoing CA.

Publication types

  • Systematic Review
  • Meta-Analysis

MeSH terms

  • Atrial Fibrillation* / surgery
  • Atrial Natriuretic Factor
  • Biomarkers
  • Catheter Ablation*
  • Humans
  • Natriuretic Peptide, Brain
  • Natriuretic Peptides
  • Recurrence
  • Treatment Outcome
  • Vasodilator Agents

Substances

  • Biomarkers
  • Natriuretic Peptides
  • Natriuretic Peptide, Brain
  • Vasodilator Agents
  • Atrial Natriuretic Factor