2016


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2016/№2

Nt-proBNP and C-reactive protein as predictors of atrial fibrillation in coronary bypass surgery

Rubanenko O. A.
State Budgetary Educational Institution, “Samara State Medical University” of the RF Ministry of Health Care, Chapaevskaya 89, Samara 443099

Keywords: IHD, NT-proBNP, diagnostics, atrial fibrillation, CABG

DOI: 10.18087 / rhj.2016.2.2164

Background. In coronary bypass (CB) surgery, postoperative atrial fibrillation (POAF) is a serious complication. Role of several factors in development of POAF has been actively studied. Aim. To evaluate the effect of NT-proBNP and С-reactive protein (CRP) on development of POAF during CB in patients with IHD. Materials and methods. A prospective evaluation of 96 patients divided into two groups: group 1, patients without POAF (67 patients; 80.6 % males; mean age 57.9±7.3), group 2, patients with POAF (29 patients; 86 % males; mean age, 64.0±8.4). Levels of NT-proBNP, CRP and fibrinogen were measured on admission and after CB, at an average of 3.8±1.4 days. Results. POAF developed in 30.2 % of cases, at an average of 4.9±3.8 days. CRP and fibrinogen levels did not significantly differ between the groups. The post-surgery level of NT-proBNP was significantly higher in patients with AF (922.2±503.1 vs. 556.9±221.8 pg/ml; р=0.033). One-factor regression analysis showed that the odds ratio (OR) for development of POAF was 2.7 (95 % CI, 1.1–7.2; р=0.003) for patients with FC III angina; 2.9 (95 % CI, 1.3–8.5; р=0.004) for patients with FC III CHF; 3.5 (95 % CI, 1.7–7.6; р<0.0001) for the left ventricle dimension exceeding 41 mm; 1.5 (95 % CI, 1.03–5.6; р=0.006) for IHD duration of more than 20 months; 2.2 (95 % CI, 1.07–5.2; р=0.04) for an age older than 62; and 4.2 (95 % CI, 1.3–9.8; р=0.006) for postoperative NT-proBNP level higher than 526.6 pg /ml. After a multifactorial analysis, the predictive value remained only for the LA dimension >41 mm with OR 2.2 (95 % CI, 1.1–8.5; р=0.0001). For the rest of the data the p value became non-significant. Conclusion. CRP concentration was not associated with development of arrhythmia. At the same time, NT-proBNP was found to be an independent predictor for AF in early postoperative period of CB. The LA dimension was the only independent factor increasing the incidence of arrhythmia following surgical myocardial revascularization.
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Rubanenko O. A. Nt-proBNP and C-reactive protein as predictors of atrial fibrillation in coronary bypass surgery. Russian Heart Journal. 2016;15 (2):88–92

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