Preoperative plasma N-terminal pro-brain natriuretic peptide as a marker of cardiac risk in patients undergoing elective non-cardiac surgery
Journal
British Journal of Surgery
Journal Volume
92
Journal Issue
8
Pages
1041-1045
Date Issued
2005
Author(s)
Abstract
Background: Plasma N-terminal pro-brain natriuretic peptide (NTproBNP) is a sensitive marker for heart failure. This study tested whether the preoperative plasma level of NTproBNP could predict cardiac complications in patients undergoing non-cardiac surgery. Methods: A total of 190 consecutive patients who underwent elective non-cardiac surgery that required general anaesthesia were studied. In addition to routine preoperative evaluation, a blood sample was taken for estimation of plasma NTproBNP concentration. Postoperative cardiac complications were defined as cardiac death, acute coronary syndrome, heart failure and haemodynamic compromise from cardiac arrhythmias. Results: Fifteen of the 190 patients had a cardiac complication: four had acute coronary syndrome and 13 had congestive heart failure. NTproBNP concentration was significantly higher in patients with a cardiac complication; a level greater than 450 ng/l was predictive of cardiac complications with a sensitivity of 100 per cent and a specificity of 82-9 per cent. Other factors associated with cardiac complications were a higher American Society of Anesthesiologists grade, age and clinical cardiac impairment, but in a multivariate analysis NTproBNP level was the only independent factor. Conclusion: Preoperative plasma NTproBNP concentration may be an independent predictor of cardiac complications in patients undergoing non-cardiac surgery. Copyright ? 2005 British Journal of Surgery Society Ltd.
SDGs
Other Subjects
brain natriuretic peptide; adult; article; blood analysis; cardiovascular risk; concentration response; congestive heart failure; controlled study; disease marker; elective surgery; female; general anesthesia; heart arrhythmia; heart death; heart failure; heart muscle ischemia; hemodynamics; human; major clinical study; male; multivariate analysis; postoperative complication; preoperative evaluation; priority journal; protein blood level; Atrial Natriuretic Factor; Biological Markers; Female; Heart Diseases; Humans; Male; Middle Aged; Multivariate Analysis; Postoperative Complications; Preoperative Care; Protein Precursors; Risk Factors; Surgical Procedures, Elective
Type
journal article