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Brain natriuretic peptide is a good predictor for outcome in cardiac surgery.
Acta Anaesthesiol Scand. 2008 Feb; 52(2):182-7.AA

Abstract

BACKGROUND AND AIM

The heart secretes brain natriuretic peptide (BNP) in response to myocardial stretch. The aim of this study was to determine whether adverse effects after cardiac surgery were associated with higher serum BNP levels pre-operatively.

METHODS

One hundred and thirty-five patients undergoing various cardiac procedures were included in the study, and N-terminal pro-BNP (NT-pro-BNP) was measured pre-operatively. Post-operative complications were defined as follows: (i) a post-operative length of stay in the intensive care unit (ICU) exceeding 48 h; (ii) mortality at 28 days; (iii) the need for inotropic agents and/or intra-aortic balloon pump (IABP); and (iv) renal failure. Serum NT-pro-BNP values were compared for patients with and without complications. The serum NT-pro-BNP level was also correlated with the euroSCORE and ejection fraction (EF).

RESULTS

Pre-operative serum NT-pro-BNP levels were significantly higher in patients with an ICU length of stay of more than 2 days or death prior to post-operative day 28 (3118 ng/l vs. 705 ng/l; P < 0.001). Pre-operative serum NT-pro-BNP levels were also significantly higher in patients needing inotropic agents (2628 ng/l vs. 548 ng/l; P < 0.001) or IABP insertion (3705 ng/l vs. 935 ng/l; P = 0.001) or developing renal failure (2857 ng/l vs. 945 ng/l; P < 0.001) post-operatively. The correlation between the serum NT-pro-BNP level and euroSCORE was good (r = 0.658; P < 0.001). The receiver operating characteristic (ROC) curves were used to assess the ability of serum NT-pro-BNP, euroSCORE and EF to predict outcome after cardiac surgery. This revealed an area under the ROC curve for the length of stay in the ICU or mortality at 28 days of 0.829 for serum NT-pro-BNP, 0.814 for euroSCORE and 0.328 for EF assessed by transesophageal echocardiography, indicating that the pre-operative serum NT-pro-BNP level is a good prognostic indicator for outcome after cardiac surgery.

CONCLUSION

Serum NT-pro-BNP is a good predictor for complications after cardiac surgery, and is as good as euroSCORE and better than EF.

Authors+Show Affiliations

Faculty of Medicine, University of Iceland, Reykjavik, Iceland.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17949462

Citation

Elíasdóttir, S B., et al. "Brain Natriuretic Peptide Is a Good Predictor for Outcome in Cardiac Surgery." Acta Anaesthesiologica Scandinavica, vol. 52, no. 2, 2008, pp. 182-7.
Elíasdóttir SB, Klemenzson G, Torfason B, et al. Brain natriuretic peptide is a good predictor for outcome in cardiac surgery. Acta Anaesthesiol Scand. 2008;52(2):182-7.
Elíasdóttir, S. B., Klemenzson, G., Torfason, B., & Valsson, F. (2008). Brain natriuretic peptide is a good predictor for outcome in cardiac surgery. Acta Anaesthesiologica Scandinavica, 52(2), 182-7.
Elíasdóttir SB, et al. Brain Natriuretic Peptide Is a Good Predictor for Outcome in Cardiac Surgery. Acta Anaesthesiol Scand. 2008;52(2):182-7. PubMed PMID: 17949462.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Brain natriuretic peptide is a good predictor for outcome in cardiac surgery. AU - Elíasdóttir,S B, AU - Klemenzson,G, AU - Torfason,B, AU - Valsson,F, Y1 - 2007/10/19/ PY - 2007/10/24/pubmed PY - 2008/3/5/medline PY - 2007/10/24/entrez SP - 182 EP - 7 JF - Acta anaesthesiologica Scandinavica JO - Acta Anaesthesiol Scand VL - 52 IS - 2 N2 - BACKGROUND AND AIM: The heart secretes brain natriuretic peptide (BNP) in response to myocardial stretch. The aim of this study was to determine whether adverse effects after cardiac surgery were associated with higher serum BNP levels pre-operatively. METHODS: One hundred and thirty-five patients undergoing various cardiac procedures were included in the study, and N-terminal pro-BNP (NT-pro-BNP) was measured pre-operatively. Post-operative complications were defined as follows: (i) a post-operative length of stay in the intensive care unit (ICU) exceeding 48 h; (ii) mortality at 28 days; (iii) the need for inotropic agents and/or intra-aortic balloon pump (IABP); and (iv) renal failure. Serum NT-pro-BNP values were compared for patients with and without complications. The serum NT-pro-BNP level was also correlated with the euroSCORE and ejection fraction (EF). RESULTS: Pre-operative serum NT-pro-BNP levels were significantly higher in patients with an ICU length of stay of more than 2 days or death prior to post-operative day 28 (3118 ng/l vs. 705 ng/l; P < 0.001). Pre-operative serum NT-pro-BNP levels were also significantly higher in patients needing inotropic agents (2628 ng/l vs. 548 ng/l; P < 0.001) or IABP insertion (3705 ng/l vs. 935 ng/l; P = 0.001) or developing renal failure (2857 ng/l vs. 945 ng/l; P < 0.001) post-operatively. The correlation between the serum NT-pro-BNP level and euroSCORE was good (r = 0.658; P < 0.001). The receiver operating characteristic (ROC) curves were used to assess the ability of serum NT-pro-BNP, euroSCORE and EF to predict outcome after cardiac surgery. This revealed an area under the ROC curve for the length of stay in the ICU or mortality at 28 days of 0.829 for serum NT-pro-BNP, 0.814 for euroSCORE and 0.328 for EF assessed by transesophageal echocardiography, indicating that the pre-operative serum NT-pro-BNP level is a good prognostic indicator for outcome after cardiac surgery. CONCLUSION: Serum NT-pro-BNP is a good predictor for complications after cardiac surgery, and is as good as euroSCORE and better than EF. SN - 1399-6576 UR - https://www.unboundmedicine.com/medline/citation/17949462/Brain_natriuretic_peptide_is_a_good_predictor_for_outcome_in_cardiac_surgery_ L2 - https://doi.org/10.1111/j.1399-6576.2007.01451.x DB - PRIME DP - Unbound Medicine ER -