ArticleClinical cardiology2026
Incremental Value of NT-proBNP Over HCM-AF Score in Risk Stratification for Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy.
Article in Clinical cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHCM-AF score is a novel risk stratification tool for atrial fibrillation (AF) in hypertrophic cardiomyopathy (HCM). N-terminal pro-brain natriuretic peptide (NT-proBNP) has shown promise in predicting AF. We aim to explore the incremental value of NT-proBNP over HCM-AF score.
methodsIn this retrospective cohort study, 778 HCM patients were included. The primary endpoint was new-onset AF. Spline curve analysis was conducted to identify the cut-off value of NT-proBNP. Harrell's C-index and likelihood ratio test were conducted to explore the incremental value.
resultsAfter a follow-up of 3.4 ± 2.3 years, AF occurred in 65 (8.4%) patients. The cut-off of NT-proBNP was 240 pg/mL. Incidence rates of AF per 1000 person-years for the low, intermediate, and high HCM-AF score groups were 8.7 (95% confidence interval [CI]: 3.5-17.7), 18.0 (95% CI: 7.7-48.8), and 59.6 (95% CI: 27.1-157.1), respectively, with the high HCM-AF score group significantly higher. For the low and high NT-proBNP groups, incidence rates were 9.2 (95% CI: 4.6-16.1) and 38.1 (95% CI: 20.3-79.4), respectively. High HCM-AF score (hazard ratio [HR]: 3.55, 95% CI: 1.33-9.48; p = 0.011) and high NT-proBNP (HR: 2.49, 95% CI: 1.21-5.10; p = 0.013) are independent predictors for AF. Addition of NT-proBNP improved models based on HCM-AF score, with C-index increasing from 0.709 to 0.768 and likelihood ratio increasing from 33.15 to 51.02.
conclusionHCM-AF score is reliable and robust for Asian HCM patients. NT-proBNP demonstrated incremental value over HCM-AF score in the prediction of new-onset AF in patients with HCM. Future studies are warranted to incorporate HCM-AF score and NT-proBNP.
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