Plasma NT-proBNP levels and the risk of atrial fibrillation after major lung resection.
OBJECTIVE
Supraventricular tachyarrhythmias, most frequently atrial fibrillation (AF), occur in 8-30% of patients undergoing major pulmonary resection. The aim of this study was to characterize a biochemical marker in order to identify subjects at higher risk of postoperative AF. The authors tested the hypothesis that elevated preoperative plasma levels of N-terminal brain-type natriuretic peptide (NT-pro-BNP) may predict the occurrence of postoperative AF.


METHODS
Fifty-five consecutive patients undergoing elective major thoracic surgery were selected. All patients had 12-lead electrocardiogram and transthoracic echocardiographic evaluation at entry. Plasma NT-pro BNP levels were determined both at baseline and at the first postoperative day. Patients were monitored thereafter to detect the occurrence of AF. For statistical analysis, an unpaired Student t test was used to compare continuous variables, chi(2) tests or Fischer exact tests were used for categorical variables, as needed.


RESULTS
Eight (14.54%) of the 55 patients developed AF with a peak incidence on postoperative days 2 to 3. Baseline NT-pro-BNP was more than two fold higher in patients who developed AF (506.1+/-108.4 pg/mL versus 197.7+/-54.9 pg/mL; P=0.001). Other relevant clinical and diagnostic parameters were not different in the two groups. Patients with NT-pro-BNP level above the median (113.0 pg/mL) had 8-fold increase risk of postoperative AF.


CONCLUSIONS
A preoperative elevated plasma NT-pro-BNP level was associated with the occurrence of AF in patient undergoing major thoracic surgery. Baseline NT-pro-BNP levels may be proposed as a biochemical marker to detect patients at higher risk of postoperative AF who could benefit from prophylactic therapeutic medication.
Gurgo
A M
AM
Division of Cardiology Sant'Andrea Policlinic, II Faculty od Medicine La Sapienza University, Rome, Italy. angela.maria@tiscali.it
Ciccone
A M
AM
D'Andrilli
A
A
Ibrahim
M
M
Musumeci
B
B
Quarta
G
G
Saponaro
A
A
Rendina
E A
EA
Volpe
M
M
D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011013:Pneumonectomy / Q000009:adverse effects*; D011446:Prospective Studies; D012307:Risk Factors
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain