Perioperative Levels of Troponin and BNP and the Outcome after Coronary Artery Bypass Grafting.

Autor:	Abdelrehim AR; Cardiac Surgery Department, Madina Cardiac Center, 42364 Madina, Saudi Arabia; Cardiothoracic Surgery Department Faculty of Medicine, Menoufia University, 32111 Menoufia, Egypt. ayman_elmeghawry@yahoo.com., Alnasser FA; Cardiology Department, Madina Cardiac Center, 42364 Madina, Saudi Arabia. Faisalalnasser@hotmail.com., Alnozaha FA; Cardiology Department, Madina Cardiac Center, 42364 Madina, Saudi Arabia. f_nozha@yahoo.com., Uddin MSH; Cardiac Anesthesia Department, Madina Cardiac Center, 42364 Madina, Saudi Arabia. uddinmd@yahoo.com., Sandogji HI; Cardiac Surgery Department, Madina Cardiac Center, 42364 Madina, Saudi Arabia. hsandogji@moh.gov.sa., Aynusah HR; Research Department, Taibah University, 42364 Madina, Saudi Arabia. Husin1419@outlook.sa., Alluhaybi ASS; Research Department, Taibah University, 42364 Madina, Saudi Arabia. Asim.alluhaybi@gmail.com., Alahmadi RA; Research Department, Taibah University, 42364 Madina, Saudi Arabia. Ref.ahm.44@gmail.com., Alahmadi HM; Research Department, Taibah University, 42364 Madina, Saudi Arabia. Hossam141950@gmail.com., Alharbi WM; Research Department, Madina Cardiac Center, 42364 Madina, Saudi Arabia. wamsalharbi@moh.gov.sa., Shabaan AM; Cardiac Surgery Department, Madina Cardiac Center, 42364 Madina, Saudi Arabia; Cardiothoracic Surgery Department Faculty of Medicine, 41522 Suez Canal University, Egypt. Ahshaban2014@yahoo.com.
Jazyk:	angličtina
Zdroj:	The heart surgery forum [Heart Surg Forum] 2023 May 31; Vol. 26 (3), pp. E240-E248. Date of Electronic Publication: 2023 May 31.
DOI:	10.1532/hsf.5471
Abstrakt:	Background: The independent predictive values of troponin I (cTnI) and B-type natriuretic peptide (BNP) after coronary artery bypass grafting (CABG) have been reported in several studies. However, adjustment only has been limited to preoperative risk factors. Aim: This study was conducted to assess the independent values of postoperative cTnI and BNP to predict the outcome after CABG with adjustment for preoperative risk estimates and postoperative complications and to report risk stratification gains, when considering the European System for Cardiac Operative Risk Evaluation (EuroSCORE) combined with postoperative biomarkers. Methods: This retrospective cohort study included 282 consecutive patients undergoing CABG between January 2018 and December 2021. We evaluated the preoperative and postoperative cTnI and BNP, EuroSCORE, and postoperative complications. The composite endpoint was death or cardiac-related adverse events. Results: The AUROC for postoperative cTnI was significantly higher than that of BNP (0.777 vs. 0.625, p = 0.041). The optimal cut-off values to predict the composite outcome were >4830 (pg/mL) and >6.95 (ng/mL) for BNP and cTnI, respectively. Adjustment for relevant and significant perioperative factors showed that postoperative BNP and cTnI had a high discriminatory power (C-index = 0.773 and 0.895, respectively) for predicting major adverse events. Conclusions: Postoperative BNP and cTnI are independent predictors of death or major adverse events, following CABG, and can add to the predictive power of EuroSCORE II.
Databáze:	MEDLINE
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