value of n-terminal pro-brain natriuretic peptide for embolic events risk prediction in patients with atrial fibrillation; a systematic review and meta-analysis

Introduction: a comprehensive conclusion has yet to be made about the predictive value of serum n-terminal pro-brain natriuretic peptide (nt-probnp) for stroke/systemic embolic events (see) in patients with atrial fibrillation (af). this study aims to review the evidence for evaluating the value of nt-probnp in predicting the risk of stroke/see in patients with af through a systematic review and meta-analysis. method: two independent reviewers screened all relevant studies that were retrieved from the database of medline, embase, scopus, and web of science until december 7th, 2021. the predictive value of nt-probnp in the prediction of stroke/see was recorded as hazard ratio (hr) and 95% confidence interval (95% ci). results: nine articles (38,093 patients, 3.10% stroke/see) were included in our analysis. there was no publication bias in these studies (p=0.320). our analysis showed that nt-probnp can be a good predictor of stroke/see risk in af patients, even at different cut-off values (hr=1.76; 95% ci: 1.51, 2.02; p < 0.001). subgroup analysis showed that diabetes could have a possible effect on the predictive value of nt-probnp (meta-regression coefficient = 0.042; p = 0.037). conclusion: measurement of nt-probnp during the first admission could be used to assess the short- or long-term risk of stroke/see in patients with af. further studies are needed to evaluate the possible applicability of serum nt-probnp measurement in the settings in which stroke is the sole outcome of the investigation.