BACKGROUND: Atrial fibrillation (AF) is a common complication after coronary artery bypass grafting (CABG). We prospectively compared the ability of echocardiographic parameters and the cardiac neurohormones, brain natriuretic peptide (BNP), and N-terminal pro-brain natriuretic peptide (NT-proBNP) to predict AF in this setting. METHODS: We recruited 275 patients undergoing nonemergency CABG. Patients undergoing valve surgery or with prior atrial dysrhythmia (based on clinical history and review of medical records) were excluded. Echocardiography was performed, and natriuretic peptide levels were measured, 24 hours before surgery. The primary end point was postoperative AF lasting >30 seconds. RESULTS: The only significant echocardiographic predictors of postoperative AF (n = 107, 39%) were the transmitral E to A-wave ratio and the early mitral annulus velocity. Levels of BNP and NT-proBNP were higher in patients who developed AF. Both natriuretic peptides, but none of the echocardiographic parameters, remained independently predictive in multivariable analysis. The optimum cut points for predicting AF were 31 pg/mL for BNP (odds ratio [OR] 2.74, P = .001) and 74 pg/mL for NT-proBNP (OR 2.74, P = .003). CONCLUSION: Levels of BNP and NT-proBNP are independent, though modestly effective, predictors of AF after isolated CABG. In contrast, none of the echocardiographic parameters assessed, including measures of LV systolic function and filling pressure, were independently predictive.
BACKGROUND:Atrial fibrillation (AF) is a common complication after coronary artery bypass grafting (CABG). We prospectively compared the ability of echocardiographic parameters and the cardiac neurohormones, brain natriuretic peptide (BNP), and N-terminal pro-brain natriuretic peptide (NT-proBNP) to predict AF in this setting. METHODS: We recruited 275 patients undergoing nonemergency CABG. Patients undergoing valve surgery or with prior atrial dysrhythmia (based on clinical history and review of medical records) were excluded. Echocardiography was performed, and natriuretic peptide levels were measured, 24 hours before surgery. The primary end point was postoperative AF lasting >30 seconds. RESULTS: The only significant echocardiographic predictors of postoperative AF (n = 107, 39%) were the transmitral E to A-wave ratio and the early mitral annulus velocity. Levels of BNP and NT-proBNP were higher in patients who developed AF. Both natriuretic peptides, but none of the echocardiographic parameters, remained independently predictive in multivariable analysis. The optimum cut points for predicting AF were 31 pg/mL for BNP (odds ratio [OR] 2.74, P = .001) and 74 pg/mL for NT-proBNP (OR 2.74, P = .003). CONCLUSION: Levels of BNP and NT-proBNP are independent, though modestly effective, predictors of AF after isolated CABG. In contrast, none of the echocardiographic parameters assessed, including measures of LV systolic function and filling pressure, were independently predictive.
Authors: Amanda A Fox; Jochen D Muehlschlegel; Simon C Body; Stanton K Shernan; Kuang-Yu Liu; Tjorvi E Perry; Sary F Aranki; E Francis Cook; Edward R Marcantonio; Charles D Collard Journal: Anesthesiology Date: 2010-04 Impact factor: 7.892
Authors: Bas B Koolen; Joost A M Labout; Paul G H Mulder; Bastiaan M Gerritse; Tom A Rijpstra; Mohamed Bentala; Peter M J Rosseel; Nardo J M van der Meer Journal: Interact Cardiovasc Thorac Surg Date: 2013-06-20
Authors: K A Jacob; J M Dieleman; H M Nathoe; D van Osch; E E C de Waal; M J Cramer; J Kluin; D van Dijk Journal: Neth Heart J Date: 2015-03 Impact factor: 2.380
Authors: Uwe Primessnig; Peter M Deißler; Paulina Wakula; Khai Liem Tran; Felix Hohendanner; Dirk von Lewinski; Florian Blaschke; Christoph Knosalla; Volkmar Falk; Burkert Pieske; Herko Grubitzsch; Frank R Heinzel Journal: Front Cardiovasc Med Date: 2022-07-05