title: Value of plasma brain natriuretic peptide levels for predicting postoperative atrial fibrillation: a systemic review and meta-analysis.
abstract: BACKGROUND
  Blood natriuretic peptide (NP) levels have been reported to be useful for predicting postoperative atrial fibrillation (AF). We aimed to quantitatively synthesize the current evidence of the accuracy of using NP levels in predicting postoperative AF.
  
  
  RESULTS
  Medline, Embase, and reference lists were searched. Studies were included if either brain natriuretic peptide (BNP) or N-terminal pro-b type natriuretic peptide (NT-proBNP) had been evaluated perioperatively to predict postoperative AF. Data were analyzed to obtain summary accuracy estimates. Data from 1,844 patients in 10 studies were analyzed. Summary estimates for the sensitivity and specificity of using NP levels for predicting postoperative AF were 75 % [95 % confidence interval (CI) 67-79 %] and 80 % (95 % CI 62-91 %), respectively. The overall diagnostic odds ratio was 3.28 (95 % CI 2.23-4.84). Subgroup analysis showed that elevated NP levels in the perioperative period were a strong independent predictor of postoperative AF. NT-proBNP appeared to have better predictive value than BNP, as did postoperative assessment over preoperative assessment. BNP had a better correlation with postoperative AF in patients undergoing thoracic surgery than in patients undergoing cardiac surgery.
  
  
  CONCLUSIONS
  Perioperative assessment of the natriuretic peptide level in patients undergoing major cardiothoracic surgery could be a valuable diagnostic aid for identifying patients at high risk of developing postoperative AF, and for providing critical clinical information to guide prophylactic antiarrhythmic therapy in the perioperative period.
authors.affiliation: Intensive Care Unit of ZheJiang Hospital, No. 12, LingYin Road, Xihu District, Hangzhou City, 310013, Zhejiang, China.
authors.forename: Guo-Long
authors.initials: GL
authors.lastname: Cai
authors.forename: Jin
authors.initials: J
authors.lastname: Chen
authors.forename: Cai-Bao
authors.initials: CB
authors.lastname: Hu
authors.forename: Mo-Lei
authors.initials: ML
authors.lastname: Yan
authors.forename: Qiang-Hong
authors.initials: QH
authors.lastname: Xu
authors.forename: Jing
authors.initials: J
authors.lastname: Yan
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis*; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011183:Postoperative Complications / Q000175:diagnosis*; D011237:Predictive Value of Tests
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain