Evidence map›Paper›PMID 26569657›Full record

Observational studyCritical pathways in cardiology2015

Addition of B-Type Natriuretic Peptide to Existing Clinical Risk Scores Enhances Identification of Patients at Risk for Atrial Fibrillation Recurrence After Pulmonary Vein Isolation.

Amir Y Shaikh, Nada Esa, William Martin-Doyle, Menhel Kinno, Iryna Nieto, Kevin C Floyd, Clifford Browning, Cynthia Ennis, J Kevin Donahue, Lawrence S Rosenthal and 1 more

Abstract readObservational Study
In one paragraph

Observational study in Critical pathways in cardiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Predicting recurrent atrial fibrillation after catheter ablation: a systematic review of prognostic models.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2020
    Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Amir Y ShaikhFrom the *Department of Medicine, University of Massachusetts Medical School, Worcester, MA; †Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; ‡Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ; §Division of Cardiology and Electrophysiology, University of Massachusetts Medical School, Worcester, MA; and ¶Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA.
Nada Esa
William Martin-Doyle
Menhel Kinno
Iryna Nieto
Kevin C Floyd
Clifford Browning
Cynthia Ennis
J Kevin Donahue
Lawrence S Rosenthal
David D McManus

Funding

TRACE-COREU01HL105268 · NHLBI · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI KIEFE, CATARINA I. · 2010 to 2013
$5.8M
Extracellular RNAs: Biomarkers for Cardiovascular Risk and DiseaseUH3TR000921 · NCATS · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI FREEDMAN, JANE E · 2015 to 2017
$3.1M
University of Massachusetts Center for Clinical and Translational ScienceKL2TR000160 · NCATS · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI LUZURIAGA, KATHERINE F · 2012 to 2014
$1.7M
University of Massachusetts Center for Clinical and Translational ScienceKL2RR031981 · NCRR · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI SULLIVAN, JOHN LEWIS · 2010 to 2011
$1.2M
Arrhythmia Detection Using a Smart PhoneR15HL121761 · NHLBI · WORCESTER POLYTECHNIC INSTITUTE · PI CHONG, JO WOON · 2014 to 2014
$389k
NCATS NIH HHS KL2 TR000160NCATS NIH HHS UH3 TR000921NCRR NIH HHS KL2 RR031981NCRR NIH HHS KL2RR031981NHLBI NIH HHS 1U01HL105268-01NHLBI NIH HHS R15 HL121761NHLBI NIH HHS U01 HL105268
6 · The paper itself

Abstract

introductionPredicting which patients will be free from atrial fibrillation (AF) after pulmonary vein isolation (PVI) remains challenging. Clinical risk prediction scores show modest ability to identify patients at risk for AF recurrence after PVI. B-type natriuretic peptide (BNP) is associated with risk for incident and recurrent AF but is not currently included in existing AF risk scores. We sought to evaluate the incremental benefit of adding preoperative BNP to existing risk scores for predicting AF recurrence during the 6 months after PVI.

methodsOne hundred sixty-one patients with paroxysmal or persistent AF underwent an index PVI procedure between 2010 and 2013; 77 patients (48%) had late AF recurrence after PVI (>3 months post-PVI) over the 6-month follow-up period.

resultsA BNP greater than or equal to 100 pg/dL (P=0.01) and AF recurrence within 3 months after PVI (P<0.001) were associated with late AF recurrence in multivariate analyses. Addition of BNP to existing clinical risk scores significantly improved the areas under the curve for each score, with an integrated discrimination improvement of 0.08 (P=0.001) and a net reclassification improvement of 60% (P=0.001) for all risk scores.

conclusionsCirculating BNP levels are independently associated with late AF recurrence after PVI. Inclusion of BNP significantly improves the discriminative ability of CHADS2, CHA2DS2-VASc, R2CHADS2, and the HATCH score in predicting clinically significant, late AF recurrence after PVI and should be incorporated in decision-making algorithms for management of AF. B-R2CHADS2 is the best score model for prediction of late AF recurrence.

Indexed as

AdultAgedAtrial FibrillationCatheter AblationCohort StudiesCryosurgeryFemaleHumansMaleMiddle AgedNatriuretic Peptide, BrainPreoperative PeriodPrognosisPulmonary VeinsRecurrenceRisk AssessmentNatriuretic Peptide, Brain

Identifiers

PMID26569657
PMCPMC4648686

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.