Atrial fibrillation after thoracic surgery for lung cancer: use of a single cut-off value of N-terminal pro-B type natriuretic peptide to identify patients at risk.
Postoperative atrial fibrillation (AF) is a well-known complication occurring after thoracic surgery. B-type natriuretic peptide has recently been investigated as a predictive marker of postoperative AF after cardiac surgery. The aim of this study was to evaluate a definite cut-off for N-terminal pro-B type natriuretic peptide (NT-proBNP) in predicting postoperative AF in lung cancer patients. NT-proBNP was determined before and after surgery in 400 patients. Cardiac function was monitored by continuous postoperative ECG and clinical cardiological evaluation. AF occurred in 18% of the patients. Receiver operating characteristic curve analyses identified a cut-off of 182.3 ng l(-1) as the one with the highest sensitivity and specificity. Perioperative increased levels of NT-proBNP seem to predict postoperative AF in patients undergoing thoracic surgery, and a single cut-off of 182.3 ng l(-1) can be used to select high-risk patients who could receive preventive therapy, leading to a considerable decrease in the total costs associated with the management of this complication.
Salvatici
Michela
M
European Institute of Oncology, Milan, Italy. michela.salvatici@ieo.it <michela.salvatici@ieo.it>
Cardinale
Daniela
D
Spaggiari
Lorenzo
L
Veglia
Fabrizio
F
Tedesco
Calogero Claudio
CC
Solli
Piergiorgio
P
Cipolla
Carlo Maria
CM
Zorzino
Laura
L
Passerini
Rita
R
Riggio
Daniela
D
Cassatella
Maria Cristina
MC
Sandri
Maria Teresa
MT
D000368:Aged; D019540:Area Under Curve; D001281:Atrial Fibrillation / Q000473:pathology*; D015415:Biomarkers / Q000097:blood; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D010455:Peptides / Q000737:chemistry; D012372:ROC Curve; D012306:Risk; D012680:Sensitivity and Specificity
D015415:Biomarkers; D010446:Peptide Fragments; D010455:Peptides; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain