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World Journal of Surgery

Published in:

01-01-2014

Value of Plasma Brain Natriuretic Peptide Levels for Predicting Postoperative Atrial Fibrillation: A Systemic Review and Meta-analysis

Authors: Guo-Long Cai, Jin Chen, Cai-Bao Hu, Mo-Lei Yan, Qiang-Hong Xu, Jing Yan

Published in: World Journal of Surgery | Issue 1/2014

Abstract

Background

Blood natriuretic peptide (NP) levels have been reported to be useful for predicting postoperative atrial fibrillation (AF). We aimed to quantitatively synthesize the current evidence of the accuracy of using NP levels in predicting postoperative AF.

Methods and Results

Medline, Embase, and reference lists were searched. Studies were included if either brain natriuretic peptide (BNP) or N-terminal pro-b type natriuretic peptide (NT-proBNP) had been evaluated perioperatively to predict postoperative AF. Data were analyzed to obtain summary accuracy estimates. Data from 1,844 patients in 10 studies were analyzed. Summary estimates for the sensitivity and specificity of using NP levels for predicting postoperative AF were 75 % [95 % confidence interval (CI) 67–79 %] and 80 % (95 % CI 62–91 %), respectively. The overall diagnostic odds ratio was 3.28 (95 % CI 2.23–4.84). Subgroup analysis showed that elevated NP levels in the perioperative period were a strong independent predictor of postoperative AF. NT-proBNP appeared to have better predictive value than BNP, as did postoperative assessment over preoperative assessment. BNP had a better correlation with postoperative AF in patients undergoing thoracic surgery than in patients undergoing cardiac surgery.

Conclusions

Perioperative assessment of the natriuretic peptide level in patients undergoing major cardiothoracic surgery could be a valuable diagnostic aid for identifying patients at high risk of developing postoperative AF, and for providing critical clinical information to guide prophylactic antiarrhythmic therapy in the perioperative period.

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Title: Value of Plasma Brain Natriuretic Peptide Levels for Predicting Postoperative Atrial Fibrillation: A Systemic Review and Meta-analysis
Authors: Guo-Long Cai
Jin Chen
Cai-Bao Hu
Mo-Lei Yan
Qiang-Hong Xu
Jing Yan
Publication date: 01-01-2014
Publisher: Springer US
Published in: World Journal of Surgery / Issue 1/2014
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-013-2284-2

At a glance: The STEP trials

Springer Medicine

Value of Plasma Brain Natriuretic Peptide Levels for Predicting Postoperative Atrial Fibrillation: A Systemic Review and Meta-analysis

Abstract

Background

Methods and Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods and Results

Conclusions

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