Predictive value of B-type natriuretic peptide for postoperative atrial fibrillation following pulmonary resection for lung cancer.
OBJECTIVE
To evaluate the usefulness of atrial natriuretic peptide (ANP) and brain B-type natriuretic peptide (BNP) for predicting postoperative atrial fibrillation (AF), we determined the changes in perioperative ANP and BNP levels in patients undergoing pulmonary resection for lung cancer.


METHODS
This prospective observational study was conducted during the 10-month period from July 2007 to April 2008. Eighty patients with lung cancer underwent lobectomy, segmentectomy or wedge resection. Preoperative evaluations included spirometry and examinations of plasma ANP and BNP-levels, which were also determined on postoperative days 1, 3 and 7.


RESULTS
Postoperative AF was identified in 22 (28%) of the patients, and those had significantly higher preoperative ANP and BNP levels as compared with patients without AF. During the postoperative course, patients with postoperative AF also had significantly higher ANP and BNP-levels. The area under the receiver-operating characteristic curve for BNP to predict postoperative AF following pulmonary resection for lung cancer was 0.90 (95% confidence interval (CI), 0.82-0.98; p<0.001). A BNP value of 30pgml(-1) had a sensitivity of 77% and a specificity of 93% for predicting postoperative AF following pulmonary resection for lung cancer.


CONCLUSIONS
Preoperative BNP level seems to be an appropriate predictor of AF after pulmonary resection.
Nojiri
Takashi
T
Department of General Thoracic Surgery, Toneyama National Hospital, Toneyama, 5-1-1, Toyonaka-City, 560-8552 Osaka, Japan. nojirit@thoracic.med.osaka-u.ac.jp
Maeda
Hajime
H
Takeuchi
Yukiyasu
Y
Funakoshi
Yasunobu
Y
Kimura
Toru
T
Maekura
Ryoji
R
Yamamoto
Kazuhiro
K
Okumura
Meinoshin
M
D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology*; D009320:Atrial Natriuretic Factor / Q000097:blood; D015415:Biomarkers / Q000097:blood; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011013:Pneumonectomy / Q000009:adverse effects*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D014797:Vital Capacity
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor