ArticleBMC cardiovascular disorders2025
N-terminal pro-brain natriuretic peptide as a predictor of postoperative atrial fibrillation in off-pump coronary artery bypass grafting patients.
Article in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivePostoperative atrial fibrillation (POAF) is a common complication following off-pump coronary artery bypass grafting (CABG). This study aims to assess whether elevated preoperative N-terminal pro-brain natriuretic peptide (NT-proBNP) levels can effectively stratify patients based on their risk of developing POAF.
methodsUtilizing a retrospective database of 512 patients who underwent off-pump CABG, we compared preoperative clinical data, including NT-proBNP levels, between patients experiencing POAF lasting longer than 30 s during hospitalization and those who did not.
resultsPOAF manifested in 23.6% of patients (121 out of 512). After off-pump CABG, 39% of patients (100 out of 256) with NT-proBNP levels greater than the median (388 pg/mL) developed POAF, in contrast to only 8% of patients (21 out of 256) with levels below 388 pg/mL (P < 0.0001). NT-proBNP levels were significantly higher in patients with POAF compared to those without (median, 1149 vs. 278 pg/mL; P < 0.0001). Multivariate logistic regression analysis revealed that in patients undergoing off-pump CABG, a NT-proBNP level of 388 pg/mL or greater (OR, 5.72; 95% CI, 3.24-10.48; P < 0.0001) was the only independent risk factor for POAF.
conclusionsFor patients undergoing off-pump CABG, increased age, preoperative left ventricular ejection fraction (LVEF) and left atrial diameter (LAD), creatinine levels, and a preoperative NT-proBNP level of 388 pg/mL or greater emerged as significant risk factors for POAF. Identifying individuals predisposed to POAF enables the design of trials evaluating preventive strategies to mitigate this complication.
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