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A Journal on Heart and Vascular Diseases
Official Journal of the Italian Society of Angiology and Vascular Pathology
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,752
Minerva Cardioangiologica 2008 December;56(6):581-5
Plasma NT-proBNP levels and the risk of atrial fibrillation after major lung resection
Gurgo A. M. 1, Ciccone A. M. 2, D’Andrilli A. 2, Ibrahim M. 2, Musumeci B. 1, Quarta G. 1, Saponaro A. 1, Rendina E. A. 2, Volpe M. 1
1 Division of Cardiology Sant’Andrea Policlinic, II Faculty od Medicine La Sapienza University, Rome, Italy
2 Department of Thoracic Surgery Sant’Andrea Policlinic, II Faculty of Medicine La Sapienza University, Rome, Italy
Aim. Supraventricular tachyarrhythmias, most frequently atrial fibrillation (AF), occur in 8-30% of patients undergoing major pulmonary resection. The aim of this study was to characterize a biochemical marker in order to identify subjects at higher risk of postoperative AF. The authors tested the hypothesis that elevated preoperative plasma levels of N-terminal brain-type natriuretic peptide (NT-pro-BNP) may predict the occurrence of postoperative AF.
Methods. Fifty-five consecutive patients undergoing elective major thoracic surgery were selected. All patients had 12-lead electrocardiogram and transthoracic echocardiographic evaluation at entry. Plasma NT-pro BNP levels were determined both at baseline and at the first postoperative day. Patients were monitored thereafter to detect the occurrence of AF. For statistical analysis, an unpaired Student t test was used to compare continuous variables, c2 tests or Fischer exact tests were used for categorical variables, as needed.
Results. Eight (14.54%) of the 55 patients developed AF with a peak incidence on postoperative days 2 to 3. Baseline NT-pro-BNP was more than two fold higher in patients who developed AF (506.1±108.4 pg/mL versus 197.7±54.9 pg/mL; P=0.001). Other relevant clinical and diagnostic parameters were not different in the two groups. Patients with NT-pro-BNP level above the median (113.0 pg/mL) had 8-fold increase risk of postoperative AF.
Conclusion. A preoperative elevated plasma NT-pro-BNP level was associated with the occurrence of AF in patient undergoing major thoracic surgery. Baseline NT-pro-BNP levels may be proposed as a biochemical marker to detect patients at higher risk of postoperative AF who could benefit from prophylactic therapeutic medication.