Association of Atrial Fibrillation and Amino-terminal Pro-brain Natriuretic Peptide Concentrations in Patients After Off- Pump Coronary Artery Bypass Grafting

ObjectivesToinvestigatethepossibleroleofamino-terminalpro-brainnatriureticpeptide(NT-proBNP)intheoccurrenceofatrialfibrillation(AF)aftercoronaryarterybypassgrafting(CABG).MethodsThisstudygroupincluded70consecutivepatientsscheduledforelectiveoff-pumpCABG.Thepatientswithejectionfraction(EF)lessthan0.30,historyofAF,useofclassIorIIIantiarrhythmicdrug,implantedpacemaker,postoperativemyocardialinfarctionorchestreopeningforpericardialtamponadewereexcluded.PreoperativeandpostoperativeserumNT-proBNPlevelsweremeasuredbyradioimmunoassaytechnique.ResultsPostoperativeAFoccurredin15patients(21.4%);thesepatientshadsignificantlyhighermedianNT-proBNPlevelswhencomparedwiththosewithoutAFaftertheoperation(P<0.01).Usingmultivariatelogisticregressionanalyses,anincreaseinNT-proBNPlevelafterCABGwasfoundtobeindependentlyassociatedwithAF(OR=3.78,95%IC=1.81～4.89,P<0.01).Increasedage,diabetesmellitus,preoperativeuseofβ-blocker,proximalrightcoronaryarteryinvolvement,andlongeroperationtimewerealsoassociatedwithAF.ConclusionsTheseresultsindicatedthatAFwasassociatedwithhigherNT-proBNPconcentrationsafteroffpumpCABG;theincreaseinNT-proBNPafterCABGmayplayanimportantroleintheoccurrenceofAFaftertheoperation.ThefurtherstudiesareneededtodefinethereasonthatleadtohigherNT-proBNPconcentrationsamongthepatientswhopresentAFafteroffpumpCABG.