title: Preoperative brain natriuretic peptide and atrial arrhythmias after coronary artery bypass graft surgery.
abstract: OBJECTIVE
  To assess the association of preoperative brain natriuretic peptide with atrial arrhythmias and length of stay after cardiac surgery.
  
  
  METHODS
  A retrospective data analysis.
  
  
  METHODS
  All data were collected from patients who underwent cardiac surgery at a single institution, an academic hospital, between 2005 and 2010.
  
  
  METHODS
  Patient data were collected from the authors' institution's Perioperative Health Documentation System of cardiac surgeries.
  
  
  METHODS
  None.
  
  
  RESULTS
  The major findings were that individuals with a 10-pg/mL increase in brain natriuretic peptide were 1.005 (95% CI: 1.002, 1.009) times more likely to have an atrial arrhythmia than those with no increase in brain natriuretic peptide. A brain natriuretic peptide value ≥306 pg/mL was calculated to best predict an atrial arrhythmia. Those above the threshold were 1.455 (95% CI: 1.087, 1.947) times more likely to have an atrial arrhythmia than those below the threshold. Individuals above the threshold had a median of 3 days in the intensive care unit compared to 1 day for those below the threshold, as well as median hospital stays of 11 days for those below the threshold.
  
  
  CONCLUSIONS
  The results indicated that elevated brain natriuretic peptide was associated with increased risk of atrial arrhythmias and prolonged length of hospital stay after cardiac surgery. Identifying at-risk patients is important to guide preventative strategies for postoperative atrial arrhythmias.
authors.affiliation: Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio; Uniformed Services University of the Health Sciences, Bethesda, Maryland.
authors.forename: Ethan
authors.initials: E
authors.lastname: Bernstein
authors.affiliation: Department of Public Health Sciences, University of Rochester, Rochester, New York; University of Colorado Anschutz Medical Campus Division of Cardiology, Aurora, Colorado.
authors.forename: Robert
authors.initials: R
authors.lastname: Block
authors.affiliation: Department of Public Health Sciences, University of Rochester, Rochester, New York.
authors.forename: Peter
authors.initials: P
authors.lastname: Veazie
authors.affiliation: University of Colorado Anschutz Medical Campus Division of Cardiology, Aurora, Colorado.
authors.forename: Christine
authors.initials: C
authors.lastname: Tompkins
authors.affiliation: Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio; Department of Cardiothoracic Anesthesiology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: C Allen
authors.initials: CA
authors.lastname: Bashour
authors.affiliation: Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio. Electronic address: turana@ccf.org.
authors.forename: Alparslan
authors.initials: A
authors.lastname: Turan
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011183:Postoperative Complications / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain
keywords: arrhythmias; brain; cardiac; coronary artery bypass; natriuretic peptide