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Utility of B-type natriuretic peptide in predicting postoperative complications and outcomes in patients undergoing heart surgery.
J Am Coll Cardiol. 2004 May 19; 43(10):1873-9.JACC

Abstract

OBJECTIVES

The purpose of the present study was to assess whether preoperative and postoperative B-type natriuretic peptide (BNP) levels could be used as predictors of postoperative complications and outcomes in patients after open-heart surgery.

BACKGROUND

A variety of multifactor indexes have been proposed for preoperative risk assessment of patients undergoing cardiac surgery, but they have shown limited ability and utility in accurately predicting postoperative complications, hospital stay, and mortality.

METHODS

Subjects consisted of 98 male patients (63 +/- 9.1 years) undergoing open-heart surgery at the San Diego Veterans Administration Health System during a 19-month period. B-type natriuretic peptide levels were analyzed, and postoperative data recorded.

RESULTS

There was a higher preoperative BNP level in patients requiring the use of intra-aortic balloon pumps (IABPs) (mean BNP = 387 +/- 112 pg/ml vs. 181 +/- 25 pg/ml), in patients who died within one year (357 +/- 93 pg/ml vs. 184 +/- 26 pg/ml), and in patients with postoperative hospital stays of 10 days or more (307 +/- 68 pg/ml vs. 179 +/- 27 pg/ml). Receiver operating characteristic curves demonstrated preoperative BNP levels as predictors of postoperative IABP use, hospital stay <or=10 days, and mortality <1 year with areas under the curve of 0.70, 0.64, and 0.70, respectively. A BNP cut-off value above 385 pg/ml demonstrated high specificity (=90% in each) and accuracy (=86%, 79%, 85%, respectively) for predicting each of these end points.

CONCLUSIONS

Preoperative BNP levels >385 pg/ml predict the postoperative complications and one-year mortality after heart surgery. Postoperatively, elevated peak BNP levels and elevated change to peak BNP levels were associated with prolonged hospital stay and mortality within one year.

Authors+Show Affiliations

University of California, San Diego, San Diego, California, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15145114

Citation

Hutfless, Ryan, et al. "Utility of B-type Natriuretic Peptide in Predicting Postoperative Complications and Outcomes in Patients Undergoing Heart Surgery." Journal of the American College of Cardiology, vol. 43, no. 10, 2004, pp. 1873-9.
Hutfless R, Kazanegra R, Madani M, et al. Utility of B-type natriuretic peptide in predicting postoperative complications and outcomes in patients undergoing heart surgery. J Am Coll Cardiol. 2004;43(10):1873-9.
Hutfless, R., Kazanegra, R., Madani, M., Bhalla, M. A., Tulua-Tata, A., Chen, A., Clopton, P., James, C., Chiu, A., & Maisel, A. S. (2004). Utility of B-type natriuretic peptide in predicting postoperative complications and outcomes in patients undergoing heart surgery. Journal of the American College of Cardiology, 43(10), 1873-9.
Hutfless R, et al. Utility of B-type Natriuretic Peptide in Predicting Postoperative Complications and Outcomes in Patients Undergoing Heart Surgery. J Am Coll Cardiol. 2004 May 19;43(10):1873-9. PubMed PMID: 15145114.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Utility of B-type natriuretic peptide in predicting postoperative complications and outcomes in patients undergoing heart surgery. AU - Hutfless,Ryan, AU - Kazanegra,Radmila, AU - Madani,Michael, AU - Bhalla,Meenakshi Awasthi, AU - Tulua-Tata,Alisi, AU - Chen,Amelia, AU - Clopton,Paul, AU - James,Cherimarie, AU - Chiu,Albert, AU - Maisel,Alan S, PY - 2003/10/04/received PY - 2003/12/01/revised PY - 2003/12/09/accepted PY - 2004/5/18/pubmed PY - 2004/6/30/medline PY - 2004/5/18/entrez SP - 1873 EP - 9 JF - Journal of the American College of Cardiology JO - J Am Coll Cardiol VL - 43 IS - 10 N2 - OBJECTIVES: The purpose of the present study was to assess whether preoperative and postoperative B-type natriuretic peptide (BNP) levels could be used as predictors of postoperative complications and outcomes in patients after open-heart surgery. BACKGROUND: A variety of multifactor indexes have been proposed for preoperative risk assessment of patients undergoing cardiac surgery, but they have shown limited ability and utility in accurately predicting postoperative complications, hospital stay, and mortality. METHODS: Subjects consisted of 98 male patients (63 +/- 9.1 years) undergoing open-heart surgery at the San Diego Veterans Administration Health System during a 19-month period. B-type natriuretic peptide levels were analyzed, and postoperative data recorded. RESULTS: There was a higher preoperative BNP level in patients requiring the use of intra-aortic balloon pumps (IABPs) (mean BNP = 387 +/- 112 pg/ml vs. 181 +/- 25 pg/ml), in patients who died within one year (357 +/- 93 pg/ml vs. 184 +/- 26 pg/ml), and in patients with postoperative hospital stays of 10 days or more (307 +/- 68 pg/ml vs. 179 +/- 27 pg/ml). Receiver operating characteristic curves demonstrated preoperative BNP levels as predictors of postoperative IABP use, hospital stay <or=10 days, and mortality <1 year with areas under the curve of 0.70, 0.64, and 0.70, respectively. A BNP cut-off value above 385 pg/ml demonstrated high specificity (=90% in each) and accuracy (=86%, 79%, 85%, respectively) for predicting each of these end points. CONCLUSIONS: Preoperative BNP levels >385 pg/ml predict the postoperative complications and one-year mortality after heart surgery. Postoperatively, elevated peak BNP levels and elevated change to peak BNP levels were associated with prolonged hospital stay and mortality within one year. SN - 0735-1097 UR - https://www.unboundmedicine.com/medline/citation/15145114/Utility_of_B_type_natriuretic_peptide_in_predicting_postoperative_complications_and_outcomes_in_patients_undergoing_heart_surgery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735109704004358 DB - PRIME DP - Unbound Medicine ER -