title: The use of preoperative B-type natriuretic peptide as a predictor of atrial fibrillation after thoracic surgery: systematic review and meta-analysis.
abstract: OBJECTIVE
  To determine whether elevated preoperative B-type natriuretic peptide (NP) measurements are an independent predictor of atrial fibrillation (AF) in patients having thoracic surgery.
  
  
  METHODS
  Systematic review and meta-analysis.
  
  
  METHODS
  In-hospital and 30 days after thoracic surgery.
  
  
  METHODS
  The 742 patients who participated in the 5 observational studies.
  
  
  METHODS
  None.
  
  
  RESULTS
  EMBASE, OVID Health Star, Ovid Medline, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and ProQuest Dissertations and Theses A&I databases were searched for all studies of noncardiac thoracic surgery patients in whom a preoperative NP was measured up to 1 month before surgery, and that measured the incidence of postoperative AF. Studies were included regardless of their language, sample size, publication status, or study design. Study quality was evaluated using the Newcastle Ottowa Scale. The combined incidence of postoperative AF was 14.5% (n=108/742), and the NP thresholds used to predict AF varied among studies. An elevated preoperative NP measurement was associated with an OR of 3.13 (95% CI 1.38-7.12; I2=87%) for postoperative AF, with the sensitivity analysis reporting an OR of 9.51 (95% CI 4.66-19.40; I2=0).
  
  
  CONCLUSIONS
  Patients with an elevated preoperative NP measurement are at an increased risk of postoperative AF. There may be value in incorporating NP measurement into existing AF risk prediction models.
authors.affiliation: Department of Anaesthetics, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa. Electronic address: dalesimmers@mweb.co.za.
authors.forename: Dale
authors.initials: D
authors.lastname: Simmers
authors.affiliation: Department of Anaesthetics, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Danielle
authors.initials: D
authors.lastname: Potgieter
authors.affiliation: Perioperative Research Group, Department of Anaesthetics, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
authors.forename: Lisa
authors.initials: L
authors.lastname: Ryan
authors.affiliation: Division of General, Visceral and Vascular Surgery, University Hospital Jena, Germany.
authors.forename: René
authors.initials: R
authors.lastname: Fahrner
authors.affiliation: Perioperative Research Group, Department of Anaesthetics, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Pietermaritzburg, South Africa; Department of Outcomes Research, Cleveland Clinic, Cleveland, OH.
authors.forename: Reitze Nils
authors.initials: RN
authors.lastname: Rodseth
mesh_terms: D001281:Atrial Fibrillation / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D064887:Observational Studies as Topic / Q000379:methods; D011183:Postoperative Complications / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D011237:Predictive Value of Tests; D019616:Thoracic Surgical Procedures / Q000009:adverse effects*
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain
keywords: BNP; NT-proBNP; atrial fibrillation; natriuretic peptides; noncardiac surgery; thoracic surgery