Association of N-terminal pro-brain natriuretic peptide and cardiac troponin T with in-hospital cardiac events in elderly patients undergoing coronary artery surgery.
OBJECTIVE
Despite evidence of their prognostic power for non-surgical patients, the value of perioperative natriuretic peptides and cardiac troponins as markers of cardiac events is incompletely defined. This study sought to examine whether perioperative N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin T (cTnT) levels could be used for the prediction of in-hospital cardiac events in elderly patients undergoing elective coronary artery bypass grafting.


METHODS
Ninety-eight elderly patients (>75 yr) undergoing elective coronary artery bypass grafting with cardiopulmonary bypass were enrolled and followed up for 121 and 0.66 1 for NT-proBNP and cTnT (sensitivity, specificity, positive predictive value and negative predictive value of 84.3%, 89.4%, 78.9% and 92.4%, and 93.7%, 74.2%, 63.8% and 96.1%, respectively) at 24 h after surgery to be associated with in-hospital cardiac events. An elevation of both biomarkers above these threshold values was independently associated with individual postoperative complications (odds ratio, 18.9; 95%, CI, 2.3-106.1).


CONCLUSIONS
In elderly patients undergoing elective coronary artery bypass grafting surgery, high values of NT-proBNP and cTnT measured 24 h after the end of surgery were independently associated with in-hospital cardiac events.
Suttner
S
S
Klinikum der Stadt Ludwigshafen, Department of Anaesthesiology and Intensive Care Medicine, Ludwigshafen, Germany. suttner@gmx.de
Boldt
J
J
Lang
K
K
Röhm
K D
KD
Piper
S N
SN
Mayer
J
J
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000097:blood* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011183:Postoperative Complications / Q000097:blood; D020107:Troponin T / Q000097:blood*
D015415:Biomarkers; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain