BNP和CRP在预测孤立冠状动脉搭桥术患者房颤发展中的作用

Nektarios D Pilatis, Zacharias-Alexandros Anyfantakis, Kyriakos Spiliopoulos, Dimitrios Degiannis, Antigoni Chaidaroglou, Georgia Vergou, Konstantina Kimpouri, Dennis V Cokkinos
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引用次数: 19

摘要

目标。探讨冠状动脉搭桥术后心房颤动发生与BNP和CRP的关系。方法。该系列包括125例患者(65±9岁),他们接受了孤立的冠脉搭桥手术。分别在术前和术后24小时测量BNP和CRP水平,并分析其与术后房颤发生的相关性。结果。44例(35%)患者术后发生房颤。与非房颤患者相比,他们明显更老(68±8比63±9,P = 0.01),并且主要是非吸烟者(18%比46%,P = 0.004)。此外,术前平均BNP水平为629,高于373 pg/mL (P = 0.019)。两组术后BNP水平均显著升高(af组:1032 pg/mL,非af组:705 pg/mL;P < 0.001),而af患者术后有更多升高的趋势(P = 0.065)。在BNP水平最高的两个四分位数中,af发作明显更频繁,发生率为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,术前BNP水平升高是房颤的独立预测因子(P = 0.036)。结论。术前血清BNP水平升高与冠脉搭桥后房颤的发生有关,而CRP似乎没有影响。
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The Role of BNP and CRP in Predicting the Development of Atrial Fibrillation in Patients Undergoing Isolated Coronary Artery Bypass Surgery.

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.

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