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脑钠肽(BNP)和C反应蛋白(CRP)在预测单纯冠状动脉搭桥手术患者房颤发生中的作用

The Role of BNP and CRP in Predicting the Development of Atrial Fibrillation in Patients Undergoing Isolated Coronary Artery Bypass Surgery.

作者信息

Pilatis Nektarios D, Anyfantakis Zacharias-Alexandros, Spiliopoulos Kyriakos, Degiannis Dimitrios, Chaidaroglou Antigoni, Vergou Georgia, Kimpouri Konstantina, Cokkinos Dennis V

机构信息

1st Cardiology Department, Onassis Cardiac Surgery Center, Kallithea, 17674 Athens, Greece.

1st Cardiology Department, Onassis Cardiac Surgery Center, Kallithea, 17674 Athens, Greece ; Department of Cardiology, University of Thessaly, Biopolis, P.O. Box 1400, 41110 Larissa, Greece.

出版信息

ISRN Cardiol. 2013 Dec 25;2013:235018. doi: 10.1155/2013/235018.

Abstract

Objective. To evaluate the association of BNP and CRP with the development of postoperative atrial fibrillation following coronary artery bypass grafting surgery. Methods. The series consists of 125 patients (aged 65 ± 9 years), who underwent isolated CABG-surgery. BNP and CRP levels were measured pre- and 24 hours postoperatively and their correlation to the development of postoperative AF was analyzed. Results. Forty-four patients (35%) developed AF postoperatively. They were significantly older (68 ± 8 versus 63 ± 9, P = 0.01) and predominantly nonsmokers (18% versus 46%, P = 0.004), compared to the non-AF cases. In addition they showed significant higher preoperative mean BNP levels of 629 versus 373 pg/mL (P = 0.019). Postoperative BNP levels were significantly higher in both groups (AF-group: 1032 pg/mL versus non-AF group: 705 pg/mL; P < 0.001), while there was a trend of more increased postoperative levels in AF-cases (P = 0.065). AF-episodes appeared significantly more frequent in the two highest quartiles of BNP levels with 44% (P = 0.035). On the contrary pre- and postoperative CRP levels were not associated with AF. Multivariable analysis revealed only increased preoperative BNP levels as independent predictor for postoperative AF (P = 0.036). Conclusion. Elevated preoperative BNP serum levels are associated with the development of post-CABG AF, while CRP does not seem to be influential.

摘要

目的。评估脑钠肽(BNP)和C反应蛋白(CRP)与冠状动脉旁路移植术后房颤发生的相关性。方法。该系列研究包括125例(年龄65±9岁)接受单纯冠状动脉旁路移植术的患者。在术前及术后24小时测量BNP和CRP水平,并分析它们与术后房颤发生的相关性。结果。44例患者(35%)术后发生房颤。与未发生房颤的患者相比,他们年龄显著更大(68±8岁对63±9岁,P = 0.01),且主要为非吸烟者(18%对46%,P = 0.004)。此外,他们术前平均BNP水平显著更高,为629 pg/mL对373 pg/mL(P = 0.019)。两组术后BNP水平均显著升高(房颤组:1032 pg/mL对非房颤组:705 pg/mL;P < 0.001),而房颤患者术后水平升高趋势更明显(P = 0.065)。在BNP水平最高的两个四分位数中房颤发作明显更频繁,为44%(P = 0.035)。相反,术前和术后CRP水平与房颤无关。多变量分析显示仅术前BNP水平升高是术后房颤的独立预测因素(P = 0.036)。结论。术前BNP血清水平升高与冠状动脉旁路移植术后房颤的发生相关,而CRP似乎没有影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7f4/3886441/fd438e93c64e/ISRN.CARDIOLOGY2013-235018.001.jpg

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