{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T14:53:43Z","timestamp":1753887223309,"version":"3.41.2"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,10]]},"abstract":"\n Background<\/jats:title>\n \n Circulating\n NT<\/jats:styled-content>\n \u2010proBNP (N\u2010terminal pro\u2010B\u2010type natriuretic peptide) levels, a well\u2010known indicator of atrial wall stress and remodeling, inversely correlate with body mass index. Both are strongly predictive of atrial fibrillation (\n AF<\/jats:styled-content>\n ). Their potential interaction in relation to incident AF, however, has not been explored.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n In total, 9556 participants of the ARIC (Atherosclerosis Risk in Communities) study who had 2 measurements of\n NT<\/jats:styled-content>\n \u2010pro\n BNP<\/jats:styled-content>\n and no baseline\n AF<\/jats:styled-content>\n or heart failure were followed from 1996 to 1998 through 2016 for the occurrence of incident\n AF<\/jats:styled-content>\n . Participants were categorized as obese (body mass index \u226530) and nonobese (body mass index <30) and by\n NT<\/jats:styled-content>\n \u2010pro\n BNP<\/jats:styled-content>\n levels (using the median of 68.2\u00a0pg\/\n mL<\/jats:styled-content>\n as the cutoff). Over a median follow\u2010up of 18.3\u00a0years, we identified 1806 incident cases of\n AF<\/jats:styled-content>\n . Analysis using multivariable Cox regression models showed that obese participants with high\n NT<\/jats:styled-content>\n \u2010pro\n BNP<\/jats:styled-content>\n levels at visit 4 had a higher adjusted risk of incident\n AF<\/jats:styled-content>\n (hazard ratio: 3.64; 95% CI, 3.15\u20134.22) compared with nonobese individuals with low\n NT<\/jats:styled-content>\n \u2010pro\n BNP<\/jats:styled-content>\n levels. The association of obesity with\n AF<\/jats:styled-content>\n risk was not modified by\n NT<\/jats:styled-content>\n \u2010pro\n BNP<\/jats:styled-content>\n levels (\n P<\/jats:italic>\n =0.46 for interaction). Increasing\n BNP<\/jats:styled-content>\n among participants from 1990\u20131992 to 1996\u20131998 was associated with increased\n AF<\/jats:styled-content>\n risk. After further adjustment for clinical risk factors and medications, results were similar.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Individuals who had both elevated body mass index and\n NT<\/jats:styled-content>\n \u2010pro\n BNP<\/jats:styled-content>\n and were free of clinically recognized heart failure were at higher risk of\n AF<\/jats:styled-content>\n development. Those who experienced an increase in\n NT<\/jats:styled-content>\n \u2010pro\n BNP<\/jats:styled-content>\n levels between visits 2 and 4 were at higher risk of\n AF<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.013294","type":"journal-article","created":{"date-parts":[[2019,9,28]],"date-time":"2019-09-28T09:04:07Z","timestamp":1569661447000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Joint Associations of Obesity and NT\u2010proBNP With the Incidence of Atrial Fibrillation in the ARIC Study"],"prefix":"10.1161","volume":"8","author":[{"given":"Zakaria","family":"Almuwaqqat","sequence":"first","affiliation":[{"name":"Emory School of Medicine","place":["Atlanta"]},{"name":"Emory University School of Medicine","place":["Atlanta"]},{"name":"Emory University","place":["Atlanta"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wesley T.","family":"O'Neal","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine","place":["Atlanta"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faye L.","family":"Norby","sequence":"additional","affiliation":[{"name":"University of Minnesota","place":["Minneapolis"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamela L.","family":"Lutsey","sequence":"additional","affiliation":[{"name":"University of Minnesota","place":["Minneapolis"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Selvin","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health","place":["Baltimore"]},{"name":"Johns Hopkins University","place":["Baltimore"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elsayed Z.","family":"Soliman","sequence":"additional","affiliation":[{"name":"Wake Forest School of Medicine","place":["Winston\u2010Salem"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin Y.","family":"Chen","sequence":"additional","affiliation":[{"name":"University of Minnesota Medical School","place":["Minneapolis"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alvaro","family":"Alonso","sequence":"additional","affiliation":[{"name":"Emory University","place":["Atlanta"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.16.1530"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000145546.97738.1E"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.18.2370"},{"key":"e_1_3_2_5_2","unstructured":"STATISTICS NCFH . 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