title: Effect of low-dose human atrial natriuretic peptide on postoperative atrial fibrillation in patients undergoing pulmonary resection for lung cancer: a double-blind, placebo-controlled study.
abstract: OBJECTIVE
  We previously reported that patients with preoperative B-type natriuretic peptide levels of 30 pg/mL or more have increased risk of postoperative atrial fibrillation after pulmonary resection. This study evaluated the effects of human atrial natriuretic peptide on postoperative atrial fibrillation in patients undergoing pulmonary resection for lung cancer.
  
  
  METHODS
  A prospective, randomized study was conducted with 40 patients who had preoperative elevated B-type natriuretic peptide (≥ 30 pg/mL) and underwent a scheduled pulmonary resection for lung cancer. Results were compared between patients who received low-dose human atrial natriuretic peptide and those who received a placebo. The primary end point was the incidence of postoperative atrial fibrillation during the first 4 days after surgery.
  
  
  RESULTS
  The incidence of postoperative atrial fibrillation was significantly lower in the human atrial natriuretic peptide group than in the placebo group (10% vs 60%; P < .001). Patients in the human atrial natriuretic peptide group also showed significantly lower white blood cell counts and C-reactive protein levels after surgery.
  
  
  CONCLUSIONS
  Continuous infusion of low-dose human atrial natriuretic peptide during lung cancer surgery had a prophylactic effect against postoperative atrial fibrillation after pulmonary resection in patients with preoperative elevation of B-type natriuretic peptide levels. A larger sample size is needed to establish the safety and efficacy of this intervention.
authors: Department of General Thoracic Surgery, National Hospital Organization Toneyama Hospital, Toyonaka-City, Osaka, Japan. nojirit@thoracic.med.osaka-u.ac.jp
authors: Takashi
authors: T
authors: Nojiri
authors: Kazuhiro
authors: K
authors: Yamamoto
authors: Hajime
authors: H
authors: Maeda
authors: Yukiyasu
authors: Y
authors: Takeuchi
authors: Yasunobu
authors: Y
authors: Funakoshi
authors: Masayoshi
authors: M
authors: Inoue
authors: Meinoshin
authors: M
authors: Okumura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D009320:Atrial Natriuretic Factor / Q000008:administration & dosage* / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007263:Infusions, Parenteral; D007564:Japan; D007958:Leukocyte Count; D008175:Lung Neoplasms / Q000097:blood / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010919:Placebos; D011013:Pneumonectomy / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D000889:Anti-Arrhythmia Agents; D015415:Biomarkers; D010919:Placebos; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor; D002097:C-Reactive Protein