N-terminal pro-B-type natriuretic peptide levels and early outcome after cardiac surgery: a prospective cohort study
| Autor: | B.H. Cuthbertson, B.L. Croal, D. Rae, P.H. Gibson, J.D. McNeilly, R.R. Jeffrey, W. Cairns Smith, G.J. Prescott, K.G. Buchan, H. El-Shafei, G.A. Gibson, G.S. Hillis |
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| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty medicine.drug_class Preoperative care law.invention law Internal medicine Natriuretic Peptide Brain Preoperative Care medicine Natriuretic peptide Humans Cardiac Surgical Procedures Coronary Artery Bypass Prospective cohort study Aged business.industry EuroSCORE Odds ratio Length of Stay Middle Aged Prognosis Intensive care unit Peptide Fragments Surgery Cardiac surgery Intensive Care Units Anesthesiology and Pain Medicine Treatment Outcome Scotland Female business Epidemiologic Methods Biomarkers Cohort study |
| Zdroj: | British journal of anaesthesia. 103(5) |
| ISSN: | 1471-6771 |
| Popis: | N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a powerful predictor of cardiovascular outcome in many circumstances. There are, however, limited data regarding the utility of NT-proBNP or BNP levels in patients undergoing cardiac surgery. The current study assesses the ability of NT-proBNP to predict early outcome in this setting.One thousand and ten patients undergoing non-emergent cardiac surgery were recruited prospectively. Baseline clinical details were obtained and the European System for Cardiac Operative Risk Evaluation (EuroSCORE) and Parsonnet score were calculated. Preoperative NT-proBNP levels were measured using the Roche Elecsys assay. The primary endpoint was 30 day mortality.Median NT-proBNP levels were 624 ng litre(-1) among patients who died within 30 days of surgery (n=29), compared with 279 ng litre(-1) in survivors [odds ratio (OR) 1.03 per 250 ng litre(-1), 95% confidence interval 1.01-1.05, P=0.001). NT-proBNP levels remained predictors of 30 day mortality in models including either the additive EuroSCORE (OR 1.03 per 250 ng litre(-1), P=0.01), the logistic EuroSCORE (OR 1.03 per 250 ng litre(-1), P=0.004), or the Parsonnet score (OR 1.02 per 250 ng litre(-1), P=0.04). Levels of NT-proBNP were also predictors of prolonged (1 day) stay in the intensive care unit (OR 1.03 per 250 ng litre(-1), P0.001) and of a hospital stay1 week (OR 1.07 per 250 ng litre(-1), P0.001). They remained predictive of these outcomes in regression models that included either the EuroSCORE or the Parsonnet score and in a model that included all study variables.NT-proBNP levels predict early outcome after cardiac surgery. Their prognostic utility is modest-but is independent of traditional indicators and conventional risk prediction scores. |
| Databáze: | OpenAIRE |
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