Objective. To investigate the relationship between brain natriuretic peptide (BNP) and thromboembolic events in elderly patients with nonvalvular atrial fibrillation (NVAF). Methods. This is a prospective cohort study, and based on the inclusion and exclusion criteria, 180 elderly patients with NVAF were included. The patients received follow-up appointments in the clinic or by telephone every 6 months after the beginning of the study. The primary follow-up endpoints were thromboembolic and atherosclerotic events, including ischaemic stroke, myocardial infarction, and systemic embolism. The secondary endpoints were adverse events, including cardiovascular death, all-cause death, and hospitalisation for heart failure. Patients were divided into three groups according to their BNP level at admission: group A (BNP ≤334.5 pg/mL), group B (BNP = 334.5–1,288 pg/mL), and group C (BNP ≥1,288 pg/mL). Results. A total of 180 patients were enrolled in this study, with 50 patients in group A, 68 in group B, and 62 in group C. Compared with groups A and B, group C had a higher CHA2DS2-VASc score (Z = 15.142; ) and a lower ejection fraction (EF) value (Z = 119.893; ). The left atrium (LA) and left ventricular end-diastolic diameter (LVEDD) were larger (Z = 105.031; and Z = 74.430; ), respectively, suggesting that patients with significantly increased BNP had a higher risk of thromboembolism and atherosclerosis, lower EF, larger LA and LVEDD, and worse cardiac function. After 1 year of follow-up, the incidence of primary endpoint events (χ² = 9.556; ) and secondary endpoint events (χ² = 59.485; ) in group C were higher than those in groups A and B. Conclusion. Higher BNP levels may be an independent risk factor for thromboembolic and atherosclerotic events in elderly patients with NVAF. The higher the BNP level, the greater the risk of thromboembolic and atherosclerotic events.

中文翻译：

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脑钠肽与老年非瓣膜性房颤血栓栓塞事件的关系

客观的。探讨脑钠肽（BNP）与老年非瓣膜性心房颤动（NVAF）患者血栓栓塞事件的关系。方法。这是一项前瞻性队列研究，根据纳入和排除标准，纳入了 180 名老年 NVAF 患者。研究开始后，患者每 6 个月在诊所或通过电话接受一次随访预约。主要随访终点是血栓栓塞和动脉粥样硬化事件，包括缺血性中风、心肌梗死和全身性栓塞。次要终点是不良事件，包括心血管死亡、全因死亡和心力衰竭住院。根据入院时的BNP水平将患者分为三组：A组（BNP≤334.5pg/mL）、B组（BNP=334.5-1,288pg/mL）和C组（BNP≥1,288pg/mL）。结果。本研究共入组 180 例患者，其中 A 组 50 例，B 组 68 例，C 组 62 例。与 A、B 组相比，C 组 CHA2DS2-VASc 评分较高（ Z = 15.142  ；）和较低的射血分数（EF）值（ Z  = 119.893；）。左心房（LA）和左心室舒张末期内径（LVEDD）较大（ Z  = 105.031；Z = 74.430  ；）分别提示BNP显着升高的患者血栓栓塞和动脉粥样硬化的风险较高、EF较低、LA和LVEDD较大、心功能较差。随访 1 年后，主要终点事件的发生率 ( χ ²  = 9.556；)和次要终点事件 ( χ ²  = 59.485;） C组高于A、B组。结论。较高的 BNP 水平可能是老年 NVAF 患者血栓栓塞和动脉粥样硬化事件的独立危险因素。BNP 水平越高，血栓栓塞和动脉粥样硬化事件的风险就越大。