Perioperative brain natriuretic peptide in off-pump coronary artery bypass.
BACKGROUND
During the last decade brain natriuretic peptide (BNP) has been recognized as a useful marker for acute and chronic left ventricular dysfunction. The present study was designed to evaluate the clinical relevance of BNP before and after off-pump coronary artery bypass (OPCAB).


METHODS
One hundred and twelve patients undergoing primary OPCAB were divided into two groups by preoperative BNP levels (group A, BNP < or = 100 pg/ml and group B, BNP > 100 pg/ml). Levels of BNP and MB isoenzyme of creatine kinase (CK-MB) were measured preoperatively, 6 hours and 1 day post-operatively. Echocardiographic and clinical data were collected.


RESULTS
Patients in group A had smaller perioperative left ventricular end-diastolic dimensions (LVEDD) and greater left ventricular ejection fractions (LVEF) compared to group B (P < 0.05). Levels of BNP and CKMB increased postoperatively in both groups (P < 0.01). However, there was no relationship between postoperative BNP and CKMB at any time point. Logistic regression analyses showed that a preoperative BNP level > 100 pg/ml was an independent risk factor for ventilation > 24 hours (odds ratio, OR = 13.33; 95% CI: 1.42-125.03) and ICU stay > 72 hours (OR = 3.01; 95% CI: 1.09-8.33).


CONCLUSIONS
The baseline BNP level correlated with preoperative ventricular function and longer durations of ventilation and hospital stay after OPCAB. BNP increased early after operation. However, postoperative BNP did not correlate with myocardial injury or clinical results after OPCAB.
Wang
Zanxin
Z
Dept. of Cardiovascular Surgery, Tianjin Medical University General Hospital, Tianjin, P.R. China.
Liang
Degang
D
Fu
Qiang
Q
Jia
Liqun
L
Men
Jianlong
J
Wei
Minxin
M
D000368:Aged; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D047549:Coronary Artery Bypass, Off-Pump; D052279:Creatine Kinase, MB Form / Q000097:blood; D004452:Echocardiography; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D012121:Respiration, Artificial; D012307:Risk Factors; D018709:Statistics, Nonparametric; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000601:surgery
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain; D052279:Creatine Kinase, MB Form