Evidence map›Paper›PMID 34530738›Full record

Trial reportBMC cardiovascular disorders2021

The role of brain natriuretic peptide in atrial fibrillation: a substudy of the Substrate Modification with Aggressive Blood Pressure Control for Atrial Fibrillation (SMAC-AF) trial.

Willy Weng, Rajin Choudhury, John Sapp, Anthony Tang, Jeff S Healey, Isabelle Nault, Lena Rivard, Isabelle Greiss, Jordan Bernick, Ratika Parkash

Registry-linked trialOpen access · goldAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC cardiovascular disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00438113 (Atrial Substrate Modification With Aggressive Blood Pressure Lowering to Prevent AF), which is not on this 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
0.8field-weighted citation impact, top 26% of its field
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.

NCT00438113 phase4completednot on this map

Atrial Substrate Modification With Aggressive Blood Pressure Lowering to Prevent AF

TypeinterventionalSponsorNova Scotia Health AuthorityRan2009 to 2016Enrolled184ConditionsAtrial FibrillationArmsAggressive Blood Pressure control
3 · Its place in the literature

Who cites it

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

  1. Guideline
  2. The Role of Biochemical Cardiac Markers in Atrial Fibrillation.The Journal of innovations in cardiac rhythm management · 2023
    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

10 authors at 7 institutions in 1 country.

Willy WengUniversity of Ottawa Heart Institute, Ottawa, ON, Canada.
Rajin ChoudhuryDalhousie University, 1796 Summer Street, Rm 2501-D, Halifax Infirmary, Halifax, NS, B3H 3A7, Canada.
John SappDalhousie University, 1796 Summer Street, Rm 2501-D, Halifax Infirmary, Halifax, NS, B3H 3A7, Canada.
Anthony TangWestern University, London, ON, Canada.
Jeff S HealeyMcMaster University, Hamilton, ON, Canada.
Isabelle NaultUniversité Laval, Laval, QC, Canada.
Lena RivardMontreal Heart Institute, Montreal, QC, Canada.
Isabelle GreissCentre Hospitalier de L'Université de Montréal, Montreal, QC, Canada.
Jordan BernickUniversity of Ottawa Heart Institute, Ottawa, ON, Canada.
Ratika ParkashDalhousie University, 1796 Summer Street, Rm 2501-D, Halifax Infirmary, Halifax, NS, B3H 3A7, Canada. Ratika.Parkash@nshealth.ca.
Dalhousie University · CAUniversity of Ottawa · CACentre Hospitalier de l’Université de Montréal · CAMcMaster University · CAMontreal Heart Institute · CAUniversité Laval · CAWestern University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCatheter ablation is an established therapy for atrial fibrillation but is limited by recurrence; efforts have been made to identify biomarkers that predict recurrence. We investigated the effect of baseline NT-proBNP on AF recurrence following catheter ablation in patients randomized to aggressive (< 120/80 mmHg) or standard blood pressure management (< 140/90 mmHg) in the Substrate Modification with Aggressive Blood Pressure Control trial (SMAC-AF).

methodsThe SMAC-AF study included 173 patients resistant or intolerant to at least one class I or III antiarrhythmic drug. We studied the effect of baseline NT-proBNP on the primary outcome of AF recurrence > 3 months post-ablation.

resultsOf the 173 patients, 88 were randomized to the aggressive cohort, and 85 into the standard group. The primary outcome occurred in 61.4% of those in the aggressive arm, versus 61.2% in the standard arm. In the aggressive group, logNT-proBNP predicted recurrence (HR 1.28, p = 0.04, adjusted HR 1.43, p = 0.03), while in the standard cohort, it did not (HR 0.94, p = 0.62, adjusted HR 0.83, p = 0.22). NT-proBNP ≥ 280 pg/mL also predicted occurrence in the aggressive (HR 1.98, p = 0.02) but not the standard cohort (HR 1.00, p = 1.00).

conclusionWe conclude that pre-ablation NT-proBNP may be useful in predicting recurrence in hypertensive patients and identifying patients who benefit from aggressive blood control and upstream therapies.

trial registrationNCT00438113, registered February 21, 2007.

Indexed as

Catheter AblationCryosurgeryHeart RateAction PotentialsAgedAntihypertensive AgentsAtrial FibrillationBiomarkersBlood PressureCanadaFemaleHumansHypertensionMaleMiddle AgedNatriuretic Peptide, BrainAntihypertensive AgentsBiomarkersNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)Atrial fibrillationBiomarkerCatheter ablationRecurrence

Identifiers

PMID34530738
PMCPMC8447763
OpenAlexW3200965054

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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.