title: Carperitide and atrial fibrillation after coronary bypass grafting: the Nihon University working group study of low-dose HANP infusion therapy during cardiac surgery trial for postoperative atrial fibrillation.
abstract: BACKGROUND
  Occurrence of atrial fibrillation after cardiac surgery is associated with long-term mortality. We investigated whether infusion of human atrial natriuretic peptide (carperitide) could prevent postoperative atrial fibrillation.
  
  
  RESULTS
  A total of 668 patients who underwent isolated coronary artery bypass grafting were randomized to receive infusion of carperitide or physiological saline from the initiation of cardiopulmonary bypass. Patients were monitored continuously for 1 week after surgery to detect atrial fibrillation. The risk factors were investigated by Cox proportional hazard model. Postoperative atrial fibrillation occurred in 41 of 335 patients (12.2%) from the carperitide group versus 110 of 333 patients (32.7%) from the placebo group (P<0.0001). Postoperative levels of angiotensin-II, aldosterone, creatine kinase MB isoenzyme, human heart fatty acid-binding protein, and brain natriuretic peptide were all significantly lower in the carperitide group. The risk factors for postoperative atrial fibrillation by the Cox proportional hazard model were an age ≥70 years, emergency surgery, preoperative aldosterone level >150 ng/mL, preoperative nonuse of angiotensin receptor antagonists, preoperative use of calcium antagonists, postoperative nonuse of β-blockers, postoperative nonuse of aldosterone blockers, and nonuse of carperitide.
  
  
  CONCLUSIONS
  -Perioperative carperitide infusion reduced the occurrence of postoperative atrial fibrillation. Accordingly, carperitide could be a useful option for preventing postoperative atrial fibrillation.
  
  
  BACKGROUND
  -URL: http://www.umin.ac.jp. Unique Identifier: UMIN000003958.
authors.affiliation: From the Departments of Cardiovascular Surgery (A.S., M.I., I.Y., S.W., S.O., H.K., H.Y., H.H., M.S.) and Cardiology (T.N., T.T., S.K., Y.K., A.H.), Nihon University, School of Medicine, Tokyo, Japan. asezai.med@gmail.com.
authors.forename: Akira
authors.initials: A
authors.lastname: Sezai
authors.affiliation: From the Departments of Cardiovascular Surgery (A.S., M.I., I.Y., S.W., S.O., H.K., H.Y., H.H., M.S.) and Cardiology (T.N., T.T., S.K., Y.K., A.H.), Nihon University, School of Medicine, Tokyo, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Iida
authors.affiliation: From the Departments of Cardiovascular Surgery (A.S., M.I., I.Y., S.W., S.O., H.K., H.Y., H.H., M.S.) and Cardiology (T.N., T.T., S.K., Y.K., A.H.), Nihon University, School of Medicine, Tokyo, Japan.
authors.forename: Isamu
authors.initials: I
authors.lastname: Yoshitake
authors.affiliation: From the Departments of Cardiovascular Surgery (A.S., M.I., I.Y., S.W., S.O., H.K., H.Y., H.H., M.S.) and Cardiology (T.N., T.T., S.K., Y.K., A.H.), Nihon University, School of Medicine, Tokyo, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Wakui
authors.affiliation: From the Departments of Cardiovascular Surgery (A.S., M.I., I.Y., S.W., S.O., H.K., H.Y., H.H., M.S.) and Cardiology (T.N., T.T., S.K., Y.K., A.H.), Nihon University, School of Medicine, Tokyo, Japan.
authors.forename: Shunji
authors.initials: S
authors.lastname: Osaka
authors.affiliation: From the Departments of Cardiovascular Surgery (A.S., M.I., I.Y., S.W., S.O., H.K., H.Y., H.H., M.S.) and Cardiology (T.N., T.T., S.K., Y.K., A.H.), Nihon University, School of Medicine, Tokyo, Japan.
authors.forename: Haruka
authors.initials: H
authors.lastname: Kimura
authors.affiliation: From the Departments of Cardiovascular Surgery (A.S., M.I., I.Y., S.W., S.O., H.K., H.Y., H.H., M.S.) and Cardiology (T.N., T.T., S.K., Y.K., A.H.), Nihon University, School of Medicine, Tokyo, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Yaoita
authors.affiliation: From the Departments of Cardiovascular Surgery (A.S., M.I., I.Y., S.W., S.O., H.K., H.Y., H.H., M.S.) and Cardiology (T.N., T.T., S.K., Y.K., A.H.), Nihon University, School of Medicine, Tokyo, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Hata
authors.affiliation: From the Departments of Cardiovascular Surgery (A.S., M.I., I.Y., S.W., S.O., H.K., H.Y., H.H., M.S.) and Cardiology (T.N., T.T., S.K., Y.K., A.H.), Nihon University, School of Medicine, Tokyo, Japan.
authors.forename: Motomi
authors.initials: M
authors.lastname: Shiono
authors.affiliation: From the Departments of Cardiovascular Surgery (A.S., M.I., I.Y., S.W., S.O., H.K., H.Y., H.H., M.S.) and Cardiology (T.N., T.T., S.K., Y.K., A.H.), Nihon University, School of Medicine, Tokyo, Japan.
authors.forename: Toshiko
authors.initials: T
authors.lastname: Nakai
authors.affiliation: From the Departments of Cardiovascular Surgery (A.S., M.I., I.Y., S.W., S.O., H.K., H.Y., H.H., M.S.) and Cardiology (T.N., T.T., S.K., Y.K., A.H.), Nihon University, School of Medicine, Tokyo, Japan.
authors.forename: Tadateru
authors.initials: T
authors.lastname: Takayama
authors.affiliation: From the Departments of Cardiovascular Surgery (A.S., M.I., I.Y., S.W., S.O., H.K., H.Y., H.H., M.S.) and Cardiology (T.N., T.T., S.K., Y.K., A.H.), Nihon University, School of Medicine, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kunimoto
authors.affiliation: From the Departments of Cardiovascular Surgery (A.S., M.I., I.Y., S.W., S.O., H.K., H.Y., H.H., M.S.) and Cardiology (T.N., T.T., S.K., Y.K., A.H.), Nihon University, School of Medicine, Tokyo, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kasamaki
authors.affiliation: From the Departments of Cardiovascular Surgery (A.S., M.I., I.Y., S.W., S.O., H.K., H.Y., H.H., M.S.) and Cardiology (T.N., T.T., S.K., Y.K., A.H.), Nihon University, School of Medicine, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirayama
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D009320:Atrial Natriuretic Factor / Q000008:administration & dosage*; D015415:Biomarkers / Q000097:blood; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000401:mortality; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D004311:Double-Blind Method; D006801:Humans; D007263:Infusions, Parenteral; D007564:Japan; D053208:Kaplan-Meier Estimate; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D015415:Biomarkers; C472955:NPPA protein, human; D009320:Atrial Natriuretic Factor
keywords: atrial fibrillation; atrial natriuretic factor; brain natriuretic peptide; cardiac surgery