02232nas a2200241   4500000000100000008004100001100001300042700001400055700001900069700001700088700001400105700001500119700001400134700001600148700001800164700001100182245019300193250001500386300001100401490000800412520152400420020004601944       2009                            d1 aCroal B.1 aGibson P.1 aCuthbertson B.1 aEl-Shafei H.1 aGibson G.1 aJeffrey R.1 aBuchan K.1 aMcNeilly J.1 aHillis Graham1 aRae D.00aUse of preoperative natriuretic peptides and echocardiographic parameters in predicting new-onset atrial fibrillation after coronary artery bypass grafting: a prospective comparative study  a2009/07/22  a244-510 v1583 a<p>
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 &gt;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.
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  a1097-6744 (Electronic)0002-8703 (Linking)