Abstract
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.
Original language | English |
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Pages (from-to) | 244-251 |
Number of pages | 8 |
Journal | American Heart Journal |
Volume | 158 |
Issue number | 2 |
Early online date | 17 Jul 2009 |
DOIs | |
Publication status | Published - Aug 2009 |
Keywords
- Aged
- Atrial Fibrillation
- Coronary Artery Bypass
- Echocardiography, Doppler
- Female
- Humans
- Incidence
- Logistic Models
- Male
- Middle Aged
- Natriuretic Peptide, Brain
- Peptide Fragments
- Predictive Value of Tests
- Preoperative Care
- Prognosis
- Prospective Studies
- Stroke Volume
- Ventricular Function, Left