Pericardial fluid brain natriuretic peptide concentration was associated with a higher risk of postoperative atrial fibrillation (OR 3.0 per 50 pg/ml increase; 95% CI 1.1-8.6; P=0.04).
Cohort (n=42)
Does pericardial fluid brain natriuretic peptide concentration predict the development of postoperative atrial fibrillation in patients undergoing off-pump coronary artery bypass grafting?
Pericardial fluid BNP concentration is an independent predictor of postoperative atrial fibrillation following off-pump CABG.
Effect estimate: OR 3.0 (95% CI 1.1-8.6)
p-value: p=0.04
OBJECTIVES: Postoperative atrial fibrillation is associated with the increased incidence of morbidities and mortality. Predisposing determinants of atrial fibrillation development after off-pump coronary artery bypass grafting remain unclear. We hypothesized that pericardial fluid natriuretic peptide concentrations have a predictive value for developing postoperative atrial fibrillation in patients who have undergone off-pump coronary artery bypass grafting. METHODS: We prospectively measured atrial natriuretic peptide and brain natriuretic peptide concentrations in plasma and pericardial fluid in 42 consecutive patients undergoing off-pump coronary artery bypass grafting, then continuously observed the occurrence of atrial fibrillation following off-pump coronary artery bypass grafting until the time of discharge. RESULTS: Postoperative atrial fibrillation was documented in nine patients (21%, atrial fibrillation group), and not in 33 patients (no atrial fibrillation group). Between the groups, there was neither significant difference in plasma atrial natriuretic peptide concentrations nor in pericardial atrial natriuretic peptide concentrations. Plasma brain natriuretic peptide concentrations were comparable in both groups 56.2 (interquartile range 42.7-102.8) vs. 35.2 pg/ml (13.8-75.0), P=0.07. Pericardial fluid brain natriuretic peptide concentrations were significantly higher in the atrial fibrillation group than in the no atrial fibrillation group 188.0 (124.8-411.0) vs. 39.3 pg/ml (10.0-88.4), P=0.0001. In a multivariable logistic regression model, pericardial brain natriuretic peptide concentration was significantly associated with a higher risk of postoperative atrial fibrillation (odds ratio=3.0 every 50 pg/ml increase; 95% confidence interval, 1.1-8.6; P=0.04). CONCLUSION: Our results suggested that pericardial fluid brain natriuretic peptide concentration is independently associated with the development of atrial fibrillation after off-pump coronary artery bypass grafting.
Nakamura et al. (Fri,) conducted a cohort in Off-pump coronary artery bypass grafting (n=42). Pericardial fluid brain natriuretic peptide concentration was evaluated on Postoperative atrial fibrillation (OR 3.0, 95% CI 1.1-8.6, p=0.04). Pericardial fluid brain natriuretic peptide concentration was associated with a higher risk of postoperative atrial fibrillation (OR 3.0 per 50 pg/ml increase; 95% CI 1.1-8.6; P=0.04).