Use of preoperative natriuretic peptides and echocardiographic parameters in predicting new-onset atrial fibrillation after coronary artery bypass grafting: A prospective comparative study
Background Atrial fibrillation (AF) is a common complication after coronary artery bypass grafting (CABG). We prospectively compared the ability of echocardiographic parameters and the cardiac neurohormones, brain natriuretic peptide (BNP), and N-terminal pro-brain natriuretic peptide (NT-proBNP) to...
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| Veröffentlicht in: | The American heart journal 2009-08, Vol.158 (2), p.244-251 |
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| creator | Gibson, Patrick H., BMBCh Croal, Bernard L., MBChB, MD Cuthbertson, Brian H., MBChB, MD Rae, Daniela, RN McNeilly, Jane D., BSc, MSc, PhD Gibson, George, MBChB Jeffrey, Robert R., MBChB Buchan, Keith G., MBChB El-Shafei, Hussein, MBChB, MD Hillis, Graham S., MBChB, PhD |
| description | Background Atrial fibrillation (AF) is a common complication after coronary artery bypass grafting (CABG). We prospectively compared the ability of echocardiographic parameters and the cardiac neurohormones, brain natriuretic peptide (BNP), and N-terminal pro-brain natriuretic peptide (NT-proBNP) to predict AF in this setting. Methods We recruited 275 patients undergoing nonemergency CABG. Patients undergoing valve surgery or with prior atrial dysrhythmia (based on clinical history and review of medical records) were excluded. Echocardiography was performed, and natriuretic peptide levels were measured, 24 hours before surgery. The primary end point was postoperative AF lasting >30 seconds. Results The only significant echocardiographic predictors of postoperative AF (n = 107, 39%) were the transmitral E to A-wave ratio and the early mitral annulus velocity. Levels of BNP and NT-proBNP were higher in patients who developed AF. Both natriuretic peptides, but none of the echocardiographic parameters, remained independently predictive in multivariable analysis. The optimum cut points for predicting AF were 31 pg/mL for BNP (odds ratio [OR] 2.74, P = .001) and 74 pg/mL for NT-proBNP (OR 2.74, P = .003). Conclusion Levels of BNP and NT-proBNP are independent, though modestly effective, predictors of AF after isolated CABG. In contrast, none of the echocardiographic parameters assessed, including measures of LV systolic function and filling pressure, were independently predictive. |
| doi_str_mv | 10.1016/j.ahj.2009.04.026 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67505002</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0002870309003883</els_id><sourcerecordid>3238138221</sourcerecordid><originalsourceid>FETCH-LOGICAL-c464t-ce16b72a8d1e204d66da5d1be770d3573eb30178926aefd7e708156ab514ed8f3</originalsourceid><addsrcrecordid>eNp9kttu1DAQhiMEotvCA3CDLCF6l2Wcg51QCamqOEmVuIBeW4496XrJ2sFOivbdeDgm3RWVesGVbfmbfw7_ZNkrDmsOXLzbrvVmuy4A2jVUayjEk2zFoZW5kFX1NFsBQJE3EsqT7DSlLT1F0Yjn2QlvBW8l8FX25yYhCz0bI4YRo57cHTKvp-jmiJMzbMRxchYT094yNJtgdLQu3EY9bpZvHfUOJ4yJOb-oWGcm52-Zx9958AkntojpgfWui24YKEPwTPcUwkyIweu4ZzrSc8-6_ahTYqTdLxrv2SUphjSiuS_LhN2S7v6eptnuX2TPej0kfHk8z7KbTx9_XH3Jr799_np1eZ2bSlRTbpCLTha6sRwLqKwQVteWdygl2LKWJXYlcNm0hdDYW4kSGl4L3dW8Qtv05Vl2ftClan7NmCa1c8kgNeMxzEkJWUNNsybwzSNwG-boqTbFa6jqtmlrQRQ_UIaaSxF7NUa3ozkoDmoxVm0VGasWYxVUioylmNdH5bnboX2IODpJwNsjoJPRQx-1Ny794wou27KpgLiLA4c0sDuHUSXj0BsyLtKclQ3uv2V8eBRtBucdJfyJe0wP3apUKFDflw1cFhBagLJpyvIvalHaxg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1504598956</pqid></control><display><type>article</type><title>Use of preoperative natriuretic peptides and echocardiographic parameters in predicting new-onset atrial fibrillation after coronary artery bypass grafting: A prospective comparative study</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Gibson, Patrick H., BMBCh ; Croal, Bernard L., MBChB, MD ; Cuthbertson, Brian H., MBChB, MD ; Rae, Daniela, RN ; McNeilly, Jane D., BSc, MSc, PhD ; Gibson, George, MBChB ; Jeffrey, Robert R., MBChB ; Buchan, Keith G., MBChB ; El-Shafei, Hussein, MBChB, MD ; Hillis, Graham S., MBChB, PhD</creator><creatorcontrib>Gibson, Patrick H., BMBCh ; Croal, Bernard L., MBChB, MD ; Cuthbertson, Brian H., MBChB, MD ; Rae, Daniela, RN ; McNeilly, Jane D., BSc, MSc, PhD ; Gibson, George, MBChB ; Jeffrey, Robert R., MBChB ; Buchan, Keith G., MBChB ; El-Shafei, Hussein, MBChB, MD ; Hillis, Graham S., MBChB, PhD</creatorcontrib><description>Background Atrial fibrillation (AF) is a common complication after coronary artery bypass grafting (CABG). We prospectively compared the ability of echocardiographic parameters and the cardiac neurohormones, brain natriuretic peptide (BNP), and N-terminal pro-brain natriuretic peptide (NT-proBNP) to predict AF in this setting. Methods We recruited 275 patients undergoing nonemergency CABG. Patients undergoing valve surgery or with prior atrial dysrhythmia (based on clinical history and review of medical records) were excluded. Echocardiography was performed, and natriuretic peptide levels were measured, 24 hours before surgery. The primary end point was postoperative AF lasting >30 seconds. Results The only significant echocardiographic predictors of postoperative AF (n = 107, 39%) were the transmitral E to A-wave ratio and the early mitral annulus velocity. Levels of BNP and NT-proBNP were higher in patients who developed AF. Both natriuretic peptides, but none of the echocardiographic parameters, remained independently predictive in multivariable analysis. The optimum cut points for predicting AF were 31 pg/mL for BNP (odds ratio [OR] 2.74, P = .001) and 74 pg/mL for NT-proBNP (OR 2.74, P = .003). Conclusion Levels of BNP and NT-proBNP are independent, though modestly effective, predictors of AF after isolated CABG. In contrast, none of the echocardiographic parameters assessed, including measures of LV systolic function and filling pressure, were independently predictive.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/j.ahj.2009.04.026</identifier><identifier>PMID: 19619701</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Aged ; Atrial Fibrillation - blood ; Atrial Fibrillation - diagnostic imaging ; Atrial Fibrillation - epidemiology ; Atrial Fibrillation - etiology ; Biological and medical sciences ; Cardiac arrhythmia ; Cardiac dysrhythmias ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular system ; Coronary Artery Bypass - adverse effects ; Coronary heart disease ; Coronary vessels ; Echocardiography, Doppler ; Female ; Heart ; Humans ; Incidence ; Investigative techniques, diagnostic techniques (general aspects) ; Logistic Models ; Male ; Medical sciences ; Middle Aged ; Natriuretic Peptide, Brain - blood ; Peptide Fragments - blood ; Peptides ; Predictive Value of Tests ; Preoperative Care ; Prognosis ; Prospective Studies ; Stroke Volume ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart ; Ultrasonic investigative techniques ; Ventricular Function, Left - physiology</subject><ispartof>The American heart journal, 2009-08, Vol.158 (2), p.244-251</ispartof><rights>Mosby, Inc.</rights><rights>2009 Mosby, Inc.</rights><rights>2009 INIST-CNRS</rights><rights>Copyright Elsevier Limited Aug 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c464t-ce16b72a8d1e204d66da5d1be770d3573eb30178926aefd7e708156ab514ed8f3</citedby><cites>FETCH-LOGICAL-c464t-ce16b72a8d1e204d66da5d1be770d3573eb30178926aefd7e708156ab514ed8f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002870309003883$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21793840$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19619701$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gibson, Patrick H., BMBCh</creatorcontrib><creatorcontrib>Croal, Bernard L., MBChB, MD</creatorcontrib><creatorcontrib>Cuthbertson, Brian H., MBChB, MD</creatorcontrib><creatorcontrib>Rae, Daniela, RN</creatorcontrib><creatorcontrib>McNeilly, Jane D., BSc, MSc, PhD</creatorcontrib><creatorcontrib>Gibson, George, MBChB</creatorcontrib><creatorcontrib>Jeffrey, Robert R., MBChB</creatorcontrib><creatorcontrib>Buchan, Keith G., MBChB</creatorcontrib><creatorcontrib>El-Shafei, Hussein, MBChB, MD</creatorcontrib><creatorcontrib>Hillis, Graham S., MBChB, PhD</creatorcontrib><title>Use of preoperative natriuretic peptides and echocardiographic parameters in predicting new-onset atrial fibrillation after coronary artery bypass grafting: A prospective comparative study</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Background Atrial fibrillation (AF) is a common complication after coronary artery bypass grafting (CABG). We prospectively compared the ability of echocardiographic parameters and the cardiac neurohormones, brain natriuretic peptide (BNP), and N-terminal pro-brain natriuretic peptide (NT-proBNP) to predict AF in this setting. Methods We recruited 275 patients undergoing nonemergency CABG. Patients undergoing valve surgery or with prior atrial dysrhythmia (based on clinical history and review of medical records) were excluded. Echocardiography was performed, and natriuretic peptide levels were measured, 24 hours before surgery. The primary end point was postoperative AF lasting >30 seconds. Results The only significant echocardiographic predictors of postoperative AF (n = 107, 39%) were the transmitral E to A-wave ratio and the early mitral annulus velocity. Levels of BNP and NT-proBNP were higher in patients who developed AF. Both natriuretic peptides, but none of the echocardiographic parameters, remained independently predictive in multivariable analysis. The optimum cut points for predicting AF were 31 pg/mL for BNP (odds ratio [OR] 2.74, P = .001) and 74 pg/mL for NT-proBNP (OR 2.74, P = .003). Conclusion Levels of BNP and NT-proBNP are independent, though modestly effective, predictors of AF after isolated CABG. In contrast, none of the echocardiographic parameters assessed, including measures of LV systolic function and filling pressure, were independently predictive.</description><subject>Aged</subject><subject>Atrial Fibrillation - blood</subject><subject>Atrial Fibrillation - diagnostic imaging</subject><subject>Atrial Fibrillation - epidemiology</subject><subject>Atrial Fibrillation - etiology</subject><subject>Biological and medical sciences</subject><subject>Cardiac arrhythmia</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular system</subject><subject>Coronary Artery Bypass - adverse effects</subject><subject>Coronary heart disease</subject><subject>Coronary vessels</subject><subject>Echocardiography, Doppler</subject><subject>Female</subject><subject>Heart</subject><subject>Humans</subject><subject>Incidence</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Natriuretic Peptide, Brain - blood</subject><subject>Peptide Fragments - blood</subject><subject>Peptides</subject><subject>Predictive Value of Tests</subject><subject>Preoperative Care</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Stroke Volume</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><subject>Ultrasonic investigative techniques</subject><subject>Ventricular Function, Left - physiology</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kttu1DAQhiMEotvCA3CDLCF6l2Wcg51QCamqOEmVuIBeW4496XrJ2sFOivbdeDgm3RWVesGVbfmbfw7_ZNkrDmsOXLzbrvVmuy4A2jVUayjEk2zFoZW5kFX1NFsBQJE3EsqT7DSlLT1F0Yjn2QlvBW8l8FX25yYhCz0bI4YRo57cHTKvp-jmiJMzbMRxchYT094yNJtgdLQu3EY9bpZvHfUOJ4yJOb-oWGcm52-Zx9958AkntojpgfWui24YKEPwTPcUwkyIweu4ZzrSc8-6_ahTYqTdLxrv2SUphjSiuS_LhN2S7v6eptnuX2TPej0kfHk8z7KbTx9_XH3Jr799_np1eZ2bSlRTbpCLTha6sRwLqKwQVteWdygl2LKWJXYlcNm0hdDYW4kSGl4L3dW8Qtv05Vl2ftClan7NmCa1c8kgNeMxzEkJWUNNsybwzSNwG-boqTbFa6jqtmlrQRQ_UIaaSxF7NUa3ozkoDmoxVm0VGasWYxVUioylmNdH5bnboX2IODpJwNsjoJPRQx-1Ny794wou27KpgLiLA4c0sDuHUSXj0BsyLtKclQ3uv2V8eBRtBucdJfyJe0wP3apUKFDflw1cFhBagLJpyvIvalHaxg</recordid><startdate>20090801</startdate><enddate>20090801</enddate><creator>Gibson, Patrick H., BMBCh</creator><creator>Croal, Bernard L., MBChB, MD</creator><creator>Cuthbertson, Brian H., MBChB, MD</creator><creator>Rae, Daniela, RN</creator><creator>McNeilly, Jane D., BSc, MSc, PhD</creator><creator>Gibson, George, MBChB</creator><creator>Jeffrey, Robert R., MBChB</creator><creator>Buchan, Keith G., MBChB</creator><creator>El-Shafei, Hussein, MBChB, MD</creator><creator>Hillis, Graham S., MBChB, PhD</creator><general>Mosby, Inc</general><general>Mosby</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20090801</creationdate><title>Use of preoperative natriuretic peptides and echocardiographic parameters in predicting new-onset atrial fibrillation after coronary artery bypass grafting: A prospective comparative study</title><author>Gibson, Patrick H., BMBCh ; Croal, Bernard L., MBChB, MD ; Cuthbertson, Brian H., MBChB, MD ; Rae, Daniela, RN ; McNeilly, Jane D., BSc, MSc, PhD ; Gibson, George, MBChB ; Jeffrey, Robert R., MBChB ; Buchan, Keith G., MBChB ; El-Shafei, Hussein, MBChB, MD ; Hillis, Graham S., MBChB, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c464t-ce16b72a8d1e204d66da5d1be770d3573eb30178926aefd7e708156ab514ed8f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Aged</topic><topic>Atrial Fibrillation - blood</topic><topic>Atrial Fibrillation - diagnostic imaging</topic><topic>Atrial Fibrillation - epidemiology</topic><topic>Atrial Fibrillation - etiology</topic><topic>Biological and medical sciences</topic><topic>Cardiac arrhythmia</topic><topic>Cardiac dysrhythmias</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Cardiovascular system</topic><topic>Coronary Artery Bypass - adverse effects</topic><topic>Coronary heart disease</topic><topic>Coronary vessels</topic><topic>Echocardiography, Doppler</topic><topic>Female</topic><topic>Heart</topic><topic>Humans</topic><topic>Incidence</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>Peptide Fragments - blood</topic><topic>Peptides</topic><topic>Predictive Value of Tests</topic><topic>Preoperative Care</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Stroke Volume</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><topic>Ultrasonic investigative techniques</topic><topic>Ventricular Function, Left - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gibson, Patrick H., BMBCh</creatorcontrib><creatorcontrib>Croal, Bernard L., MBChB, MD</creatorcontrib><creatorcontrib>Cuthbertson, Brian H., MBChB, MD</creatorcontrib><creatorcontrib>Rae, Daniela, RN</creatorcontrib><creatorcontrib>McNeilly, Jane D., BSc, MSc, PhD</creatorcontrib><creatorcontrib>Gibson, George, MBChB</creatorcontrib><creatorcontrib>Jeffrey, Robert R., MBChB</creatorcontrib><creatorcontrib>Buchan, Keith G., MBChB</creatorcontrib><creatorcontrib>El-Shafei, Hussein, MBChB, MD</creatorcontrib><creatorcontrib>Hillis, Graham S., MBChB, PhD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gibson, Patrick H., BMBCh</au><au>Croal, Bernard L., MBChB, MD</au><au>Cuthbertson, Brian H., MBChB, MD</au><au>Rae, Daniela, RN</au><au>McNeilly, Jane D., BSc, MSc, PhD</au><au>Gibson, George, MBChB</au><au>Jeffrey, Robert R., MBChB</au><au>Buchan, Keith G., MBChB</au><au>El-Shafei, Hussein, MBChB, MD</au><au>Hillis, Graham S., MBChB, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Use of preoperative natriuretic peptides and echocardiographic parameters in predicting new-onset atrial fibrillation after coronary artery bypass grafting: A prospective comparative study</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2009-08-01</date><risdate>2009</risdate><volume>158</volume><issue>2</issue><spage>244</spage><epage>251</epage><pages>244-251</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>Background Atrial fibrillation (AF) is a common complication after coronary artery bypass grafting (CABG). We prospectively compared the ability of echocardiographic parameters and the cardiac neurohormones, brain natriuretic peptide (BNP), and N-terminal pro-brain natriuretic peptide (NT-proBNP) to predict AF in this setting. Methods We recruited 275 patients undergoing nonemergency CABG. Patients undergoing valve surgery or with prior atrial dysrhythmia (based on clinical history and review of medical records) were excluded. Echocardiography was performed, and natriuretic peptide levels were measured, 24 hours before surgery. The primary end point was postoperative AF lasting >30 seconds. Results The only significant echocardiographic predictors of postoperative AF (n = 107, 39%) were the transmitral E to A-wave ratio and the early mitral annulus velocity. Levels of BNP and NT-proBNP were higher in patients who developed AF. Both natriuretic peptides, but none of the echocardiographic parameters, remained independently predictive in multivariable analysis. The optimum cut points for predicting AF were 31 pg/mL for BNP (odds ratio [OR] 2.74, P = .001) and 74 pg/mL for NT-proBNP (OR 2.74, P = .003). Conclusion Levels of BNP and NT-proBNP are independent, though modestly effective, predictors of AF after isolated CABG. In contrast, none of the echocardiographic parameters assessed, including measures of LV systolic function and filling pressure, were independently predictive.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>19619701</pmid><doi>10.1016/j.ahj.2009.04.026</doi><tpages>8</tpages></addata></record> |
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| subjects | Aged Atrial Fibrillation - blood Atrial Fibrillation - diagnostic imaging Atrial Fibrillation - epidemiology Atrial Fibrillation - etiology Biological and medical sciences Cardiac arrhythmia Cardiac dysrhythmias Cardiology Cardiology. Vascular system Cardiovascular Cardiovascular system Coronary Artery Bypass - adverse effects Coronary heart disease Coronary vessels Echocardiography, Doppler Female Heart Humans Incidence Investigative techniques, diagnostic techniques (general aspects) Logistic Models Male Medical sciences Middle Aged Natriuretic Peptide, Brain - blood Peptide Fragments - blood Peptides Predictive Value of Tests Preoperative Care Prognosis Prospective Studies Stroke Volume Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Ultrasonic investigative techniques Ventricular Function, Left - physiology |
| title | Use of preoperative natriuretic peptides and echocardiographic parameters in predicting new-onset atrial fibrillation after coronary artery bypass grafting: A prospective comparative study |
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