NT-proBNP Measurements to Rule-out Heart Failure among Patients with Atrial Fibrillation: A Prospective Clinical Study


The aim of the study is to investigate if NT-proBNP can rule out heart failure in atrial fibrillation patients admitted to hospital.      


Heart failure and atrial fibrillation often co-exist. N-terminal pro brain natriuretic peptide (NT-proBNP) demonstrates a high diagnostic performance for ruling out heart failure among patients in sinus rhythm. Atrial fibrillation itself increases the level of NT-proBNP in the blood. The diagnostic performance of NT-proBNP and the optimal cut-off value for atrial fibrillation patients in ruling out heart failure is unknown.    

Study design and setting

This is a prospective, observational clinical study including atrial fibrillation patients admitted to the Emergency Department and the Acute Heart Clinic at Randers Regional Hospital, Denmark. The diagnostic examinations include blood-sampling upon admission for quantification of NT-proBNP levels, an echocardiogram performed within 48 hours, and a chest x-ray.


The primary outcome is the optimal NT-proBNP cut-off level that rules out heart failure with reduced ejection fraction (≤40%) among atrial fibrillation patients.


Early rule-out of heart failure in the Emergency Department can result in the initiation of an optimal treatment strategy. This may not only be cost-effective but could also improve the treatment of the thousands of patients admitted to hospital each year with atrial fibrillation.


Anders Sjørslev Schmidt, MD

Kasper Glerup Lauridsen, MD 

Farhad Waziri, MD, PhD

Camilla Bang, MD

Christian Bo Poulsen, MD, PhD

Hans Rickers, MD

Professor Bo Løfgren, MD, PhD, FESC, FAHA (main supervisor)

Dung Thuy Nguyen, MB