Increased N-terminal pro-brain natriuretic peptide level predicts atrial fibrillation after surgery for esophageal carcinoma.

Abstract:

AIM:To evaluate the value of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) level for predicting postoperative atrial fibrillation (AF) in patients undergoing surgery for esophageal carcinoma. METHODS:NT-proBNP levels were measured in 142 patients 24 h before and 1 h after surgery for esophageal carcinoma. All patients having a preoperative cardiac diagnosis by electrocardiogram (ECG), remained under continuous monitoring for at least 48 h after surgery, and then underwent clinical cardiac evaluation until discharge. RESULTS:Postoperative AF occurred in 11 patients (7.7%). AF patients were significantly older (69.6 +/- 12.2 years vs 63.4 +/- 13.3 years, P = 0.031) than non-AF patients. There were no significant differences in history of diabetes mellitus, sex distribution, surgical approach, anastomosis site, intraoperative hypotension and postoperative fever. The preoperative plasma NT-proBNP level was significantly higher in patients who developed postoperative AF (121.3 +/- 18.3 pg/mL vs 396.1 +/- 42.6 pg/mL, P = 0.016). After adjustment for age, gender, chronic obstructive pulmonary disease (COPD), history of cardiac diseases, hypertension, postoperative hypoxia and thoracic-gastric dilation, NT-proBNP levels were found to be associated with the highest risk factor for postoperative AF (odds ratio = 4.711, 95% CI = 1.212 to 7.644, P = 0.008). CONCLUSION:An elevated perioperative plasma BNP level is a strong and independent predictor of postoperative AF in patients undergoing surgery for esophageal carcinoma. This finding has important implications for identifying patients at higher risk of postoperative AF who should be considered for preventive antiarrhythmic therapy.

journal_name

World J Gastroenterol

authors

Hou JL,Gao K,Li M,Ma JY,Shi YK,Wang Y,Zhao YF

doi

10.3748/wjg.14.2582

subject

Has Abstract

pub_date

2008-04-28 00:00:00

pages

2582-5

issue

16

eissn

1007-9327

issn

2219-2840

journal_volume

14

pub_type

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