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 = 0025. There were more emergencies in group AF (22.2%) than in group SR (10.9%), P = 015. 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 = 0006. Preoperative administration of statins was relatively greater in group SR (73.4%) than in group AF (58.3%), P = 018. Four factors with a P value 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 = 005; 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. © 2012 The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery. All rights reserved.