title: Preoperative high N-terminal pro-B-type natriuretic peptide level can predict the incidence of postoperative atrial fibrillation following off-pump coronary artery bypass grafting.
abstract: OBJECTIVE
  N-terminal pro-B type natriuretic peptide (NT-pro-BNP) is one of the biomarkers, increased by myocardial ischemia or subsequent, burdened wall stress. The aim of this study was to assess if NT-pro-BNP can predict the incidence of atrial fibrillation (AF) after off-pump coronary artery bypass grafting (OPCAB).
  
  
  METHODS
  NT-pro-BNP was measured preoperatively in 100 OPCAB patients without preoperative AF. Patients were divided into the AF group (n = 36) of those who developed postoperative AF, and the sinus rhythm (SR) group (n = 64), of those who did not. Odds ratio analysis was carried out with a logistic regression model using the threshold of the high quartile.
  
  
  RESULTS
  Age was more advanced in group AF (70.8±8.7 years old) than in group SR(66.7±8.5 years old), P = 0.025. There were more emergencies in group AF (22.2%) than in group SR (10.9%), P = 0.15. Preoperative NT-pro-BNP was significantly higher in group AF (509.6±641.6 pg/mL) than in group SR (241.1±302.7 pg/mL), P = 0.006. Preoperative administration of statins was relatively greater in group SR (73.4%) than in group AF (58.3%), P = 0.18. Four factors withaPvalue below 0.2 in the univariate analysis were extracted, which were preoperative administration of statins, emergency, high NT-pro-BNP (>348 pg/mL, high quartile), and advanced age (>75 years old, high quartile). The constructed logistic regression model revealed that high NT-pro-BNP(>348 pg/mL, high quartile) was the only predictor of postoperative AF after OPCAB(P = 0.05; OR, 2.60; 95% CI, 0.96-7.05).
  
  
  CONCLUSIONS
  A high preoperative level of NT-pro-BNP could predict the incidence of postoperative AF after OPCAB.
authors.affiliation: Department of Cardiovascular Surgery, Funabashi Municipal Medical Center, Chiba, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Matsuura
authors.forename: Kenji
authors.initials: K
authors.lastname: Mogi
authors.forename: Manabu
authors.initials: M
authors.lastname: Sakurai
authors.forename: Tomonori
authors.initials: T
authors.lastname: Kawamura
authors.forename: Takao
authors.initials: T
authors.lastname: Misue
authors.forename: Ikuo
authors.initials: I
authors.lastname: Hatakeyama
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Takahara
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology*; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D016017:Odds Ratio; D010446:Peptide Fragments / Q000097:blood*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain