title: Plasma N-terminal prohormone brain natriuretic peptide as a marker for postoperative cardiac events in high-risk patients undergoing noncardiac surgery.
abstract: This study considered if N-terminal prohormone brain natriuretic peptide (NT-proBNP) is associated with increased risk for postoperative cardiac events in high-risk patients undergoing noncardiac surgery. In addition, this report describes how levels of NT-proBNP are affected by noncardiac surgery. The study design was a prospective cohort study that enrolled 83 patients age > or =50 years with > or =1 risk factor for coronary artery disease having intermediate or high-risk noncardiac surgery. NT-proBNP levels were measured preoperatively and on postoperative days 1 and 3. During the month following surgery, 25 patients (33%) had a combined 37 postoperative cardiac events including 15 episodes of heart failure (20%), 12 episodes of new dysrhythmia (16%), 7 myocardial infarctions (9%), and 3 cardiac arrests (4%). Preoperative NT-proBNP level > or =457 pg/ml was significantly associated with occurrence of a postoperative cardiac event (odds ratio 10.5, 95% confidence interval 1.9 to 56.6, p = 0.006). After surgery, 64 of 72 patients (89%) had an increase in NT-proBNP from their preoperative level. In conclusion, this study determined there was a significant association between elevated preoperative NT-proBNP and occurrence of a postoperative cardiac event. In addition, increased NT-proBNP after noncardiac surgery is not uncommon even in the absence of clinically identifiable heart failure.
authors: Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA. rob.schutt@gmail.com
authors: Robert Clark
authors: RC
authors: Schutt
authors: Cihan
authors: C
authors: Cevik
authors: Michael P
authors: MP
authors: Phy
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D016001:Confidence Intervals; D003324:Coronary Artery Disease / Q000097:blood* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D016017:Odds Ratio; D010446:Peptide Fragments / Q000097:blood*; D011183:Postoperative Complications / Q000097:blood* / Q000209:etiology; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013997:Time Factors
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain