Predictive value of N-terminal B-type natriuretic peptide for early postoperative atrial fibrillation in patients undergoing off-pump coronary artery bypass grafting
Wei Zhipeng
Liu Keye
Luo Zhiqiang
Han Zhe
Wang Yang
Luo Zijuan
Abstract：Objective To observe the changes of blood N-terminal B-type natriuretic peptide(NT-proBNP)during perioperative period in patients undergoing off-pump coronary artery bypass grafting (OPCABG),and to evaluate the value of NT-proBNP in predicting early postoperative atrial fibrillation.Methods Sixty patients undergoing OPCABG in Affiliated Hospital of Hebei University from June 2017 to July 2018 were recruited.Blood content of NT-proBNP in blood was tested at admission,1 d before,6 h,1 d,3 d and 5 d after surgery.Predictive value of NT-proBNP before surgery for early postoperative atrial fibrillation was analyzed by receiver operating characteristic curve.Results Blood level of NT-proBNP significantly increased since 6 h after surgery and reached the peak at 3 d;the level at 5 d was still significantly higher than that before surgery[levels of NT-proBNP at admission,1 d before,6 h,1 d,3 d and 5 d after surgery:(328 ± 225),(296 ± 117),(535 ± 188),(1 254 ± 235),(1 958 ± 425),(1 152 ± 414) ng/L] (all P ＜ 0.001).Linear correlation analysis showed that NT-proBNP level at admission was negatively correlated with left ventricular ejection fraction (r =-0.624,P ＜ 0.001).Receiver operating characteristic curve revealed good predictive value of NT-proBNP at admission and 1 d before surgery for early postoperative atrial fibrillation (area under curve =0.922,0.798;95％ confidence interval:0.857-0.988,0.653-0.943;P ＜ 0.001,P =0.001;sensitivity =0.929,0.571;specificity =0.826,0.957).Logistic regression analysis showed that NT-proBNP ＞ 325 ng/L at admission(odds ratio =20.227,95％ confidence interval:1.968-207.886,P =0.011) and left ventricle end-systolic diameter (3 =-2.668,Wald =5.085,odds ratio =0.069,95％ confidence interval:0.007-0.705,P =0.024) were independent predictors of early postoperative atrial fibrillation.Conclusions NT-proBNP level in patients undergoing OPCABG significantly increases after operation;it rises within 6 h and peaks at 3 d.NT-proBNP ＞ 325 ng/L at admission is an independent predictor of early postoperative atrial fibrillation following OPCABG with high sensitivity and specificity.
Keywords：Coronary atherosclerotic heart diseaseAtrial fibrillationOff-pump coronary artery bypass graftingN-terminal B-type natriuretic peptide
Publication Date：2019-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1141-1145 )