title: Prognostic power of pre- and postoperative B-type natriuretic peptide levels in patients undergoing abdominal aortic surgery.
abstract: OBJECTIVE
  The first aim of the present study was to evaluate the pre- and postoperative B-type natriuretic peptide (BNP) levels in patients undergoing surgery for repair of an infrarenal abdominal aortic aneurysm (AAA) and analyze their power as a predictor of in-hospital cardiac events. The second aim was to evaluate the association among pre- and postoperative BNP levels, postoperative patient complications, and length of hospital stay.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  A university hospital.
  
  
  METHODS
  Forty-five patients undergoing elective surgery for an abdominal aortic aneurysm.
  
  
  METHODS
  The plasma BNP level was assessed just before surgery and then on postoperative day 1. Cardiac troponin I levels were measured postoperatively on arrival to the intensive care unit (time 0) and then 12, 48, and 72 hours later.
  
  
  RESULTS
  The preoperative BNP concentration in patients who developed an acute myocardial infarction was 209 (IQR 84-346) pg/mL compared with 74 (IQR 28-142) pg/mL in those who did not. The difference between groups was statistically significant (p = 0.04). The Spearman correlation showed that postoperative BNP levels correlated significantly with preoperative BNP levels (r = 0.73, p = 0.0001), length of hospital stay (r = 0.35, p = 0.04), and troponin I concentration at 0 hour (r = 0.42, p = 0.02), 12 hours (r = 0.51, p = 0.0052), and 48 hours (r = 0.40, p = 0.033). In contrast, preoperative BNP levels correlated with troponin I at only 12 hours (r = 0.34, p = 0.02). Postoperative BNP levels were influenced significantly by transfusions (p = 0.035) and cross-clamping times (p = 0.038).
  
  
  CONCLUSIONS
  The present results confirm the high negative predictive value of preoperative BNP levels; and postoperative BNP levels showed a better correlation with postoperative troponin levels, blood transfusion, and postoperative cardiac events.
authors.affiliation: Department of Anesthesiology and Intensive Care, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, University of Udine, Udine, Italy. vetrugnoluigi@katamail.com
authors.forename: Luigi
authors.initials: L
authors.lastname: Vetrugno
authors.forename: Maria Gabriella
authors.initials: MG
authors.lastname: Costa
authors.forename: Livia
authors.initials: L
authors.lastname: Pompei
authors.forename: Paolo
authors.initials: P
authors.lastname: Chiarandini
authors.forename: Daniela
authors.initials: D
authors.lastname: Drigo
authors.forename: Flavio
authors.initials: F
authors.lastname: Bassi
authors.forename: Nevio
authors.initials: N
authors.lastname: Gonano
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Muzzi
authors.forename: Giorgio
authors.initials: G
authors.lastname: Della Rocca
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000097:blood / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood; D011184:Postoperative Period; D011237:Predictive Value of Tests; D057234:Preoperative Period; D011379:Prognosis; D011446:Prospective Studies; D019210:Troponin I / Q000097:blood
chemical_list: D010446:Peptide Fragments; D019210:Troponin I; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain