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Updated: Apr 15, 2026

Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
Preoperative brain natriuretic peptide and atrial arrhythmias after coronary artery bypass graft surgery
Ethan Bernstein1, Robert Block2, Peter Veazie3
1Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio; Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Objective:
To assess the association of preoperative brain natriuretic peptide with atrial arrhythmias and length of stay after cardiac surgery.
Design:
A retrospective data analysis.
Setting:
All data were collected from patients who underwent cardiac surgery at a single institution, an academic hospital, between 2005 and 2010.
Participants:
Patient data were collected from the authors' institution's Perioperative Health Documentation System of cardiac surgeries.
Interventions:
None.
Measurements And Main Results:
The major findings were that individuals with a 10-pg/mL increase in brain natriuretic peptide were 1.005 (95% CI: 1.002, 1.009) times more likely to have an atrial arrhythmia than those with no increase in brain natriuretic peptide. A brain natriuretic peptide value ≥306 pg/mL was calculated to best predict an atrial arrhythmia. Those above the threshold were 1.455 (95% CI: 1.087, 1.947) times more likely to have an atrial arrhythmia than those below the threshold. Individuals above the threshold had a median of 3 days in the intensive care unit compared to 1 day for those below the threshold, as well as median hospital stays of 11 days for those below the threshold.
Conclusions:
The results indicated that elevated brain natriuretic peptide was associated with increased risk of atrial arrhythmias and prolonged length of hospital stay after cardiac surgery. Identifying at-risk patients is important to guide preventative strategies for postoperative atrial arrhythmias.
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