Relationship Between Plasma B-type Natriuretic Peptide and Postoperative Atrial Fibrillation in Patients Undergoing Cardiac Surgery

BNP Levels and AF After Cardiac Surgery

Abstract

Objective: To compare the mean B-type natriuretic peptide (BNP) levels in patients with and without atrial fibrillation in postoperative cardiac surgery.

Methodology: After ethical approval, a prospective cohort study was conducted at the Cardiac Surgery Department, Punjab Institute of Cardiology, Lahore from January 2024 to January 2025. A total of 79 patients aged 45-60 years who underwent coronary artery bypass grafting (CABG) or valvular surgery and had no preoperative history of atrial fibrillation were included using non-probability consecutive sampling. All subjects underwent electrocardiography (ECG) before and after the procedure to assess atrial fibrillation until discharge. BNP levels and routine blood chemistry were also recorded preoperatively.

Results: Atrial fibrillation (AF) occurred in 18 patients (22.8%). The mean preoperative B-type natriuretic peptide (BNP) level in patients who developed AF was 614.22 ± 1.26, compared to 443.32 ± 1.15 in those without AF (p < 0.001). Gender was significantly associated with the occurrence of AF with 5 (11.6%) males and 13 (36.1%) females diagnosed (p=0.015).

Conclusion: Preoperative B-type natriuretic peptide (BNP) levels predict postoperative AF in patients undergoing cardiac surgery. BNP levels could be used to better stratify patients in this respect.