N-terminal pro-brain natriuretic peptide identifies patients at high risk for adverse cardiac outcome after vascular surgery

Preoperative N-terminal pro-BNP (NT-proBNP) is independently associated with adverse cardiac outcome but does not anticipate the dynamic consequences of anesthesia and surgery. The authors hypothesized that a single postoperative NT-proBNP level provides additional prognostic information for in-hosp...

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Bibliographic Details
Published in:Anesthesiology (Philadelphia) 2007-06, Vol.106 (6), p.1088-1095
Main Authors: MAHLA, Elisabeth, BAUMANN, Anneliese, REHAK, Peter, WATZINGER, Norbert, VICENZI, Martin N, MAIER, Robert, TIESENHAUSEN, Kurt, METZLER, Helfried, TOLLER, Wolfgang
Format: Article
Language:English
Subjects:
Aged
Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Comorbidity
Disease-Free Survival
Female
Follow-Up Studies
Humans
Logistic Models
Male
Medical sciences
Myocardial Infarction - blood
Natriuretic Peptide, Brain - blood
Peptide Fragments - blood
Postoperative Complications - blood
Postoperative Complications - diagnosis
Preoperative Care
Prognosis
Vascular Surgical Procedures
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Summary:Preoperative N-terminal pro-BNP (NT-proBNP) is independently associated with adverse cardiac outcome but does not anticipate the dynamic consequences of anesthesia and surgery. The authors hypothesized that a single postoperative NT-proBNP level provides additional prognostic information for in-hospital and late cardiac events. Two hundred eighteen patients scheduled to undergo vascular surgery were enrolled and followed up for 24-30 months. Logistic regression and Cox proportional hazards model were performed to evaluate predictors of in-hospital and long-term cardiac outcome. The optimal discriminatory level of preoperative and postoperative NT-proBNP was determined by receiver operating characteristic analysis. During a median follow-up of 826 days, 44 patients (20%) experienced 51 cardiac events. Perioperatively, median NT-proBNP increased from 215 to 557 pg/ml (interquartile range, 83/457 to 221/1178 pg/ml; P
ISSN:0003-3022
1528-1175
DOI:10.1097/01.anes.0000267591.34626.b0