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Objective <p>Postoperative 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.</p> Methods <p>Utilizing 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&#xa0;s during hospitalization and those who did not.</p> Results <p>POAF 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 (<i>P</i> &lt; 0.0001). NT-proBNP levels were significantly higher in patients with POAF compared to those without (median, 1149 vs. 278 pg/mL; <i>P</i> &lt; 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; <i>P</i> &lt; 0.0001) was the only independent risk factor for POAF.</p> Conclusions <p>For 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.</p> Graphical abstract <p>Central image: NT-proBNP demonstrates reliable predictive efficacy for POAF in off-pump CABG patients. NT-proBNP, N-Terminal pro-Brain Natriuretic Peptide; POAF, postoperative atrial fibrillation; CABG, coronary artery bypass grafting.</p> <p></p>

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N-terminal pro-brain natriuretic peptide as a predictor of postoperative atrial fibrillation in off-pump coronary artery bypass grafting patients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月21日

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  • Xiangyu Li,
  • Zihao Shen,
  • Yuanpu Qi,
  • Mingyu Chu,
  • Minchao Wu,
  • Chen Feng,
  • Zhaoyang Liu,
  • Yongliang Wang,
  • Jialin Zhang,
  • Xiaoning Lu,
  • Peng Lu

摘要

Objective

Postoperative 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.

Methods

Utilizing 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.

Results

POAF 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.

Conclusions

For 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.

Graphical abstract

Central image: NT-proBNP demonstrates reliable predictive efficacy for POAF in off-pump CABG patients. NT-proBNP, N-Terminal pro-Brain Natriuretic Peptide; POAF, postoperative atrial fibrillation; CABG, coronary artery bypass grafting.