Influence of preoperative serum N-terminal pro-brain type natriuretic peptide on the postoperative outcome and survival rates of coronary artery bypass patients
Clinics
;
65(12): 1239-1245, 2010. graf, tab
Article
in English
| LILACS
| ID: lil-578560
ABSTRACT
BACKGROUND: The N-terminal fragment of pro-brain type natriuretic peptide (NT-proBNP) is an established biomarker for cardiac failure. OBJECTIVE: To determine the influence of preoperative serum NT-proBNP on postoperative outcome and mid-term survival in patients undergoing coronary artery bypass grafting (CABG). METHODS: In 819 patients undergoing isolated CABG surgery preoperative serum NT-proBNP levels were measured. NT-proBNP was correlated with various postoperative outcome parameters and survival rate after a median follow-up time of 18 (0.5-44) months. Risk factors of mortality were identified using χ2, Mann-Whitney test, and Cox regression. RESULTS: NT-proBNP levels >430 ng/ml and >502 ng/ml predicted hospital and overall mortality (p<0.05), with an incidence of 1.6 percent and 4 percent, respectively. Kaplan-Meier analysis revealed decreased survival rates in patients with NT-proBNP >502 ng/ml (p=0.001). Age, preoperative serum creatinine, diabetes, chronic obstructive pulmonary disease, low left ventricular ejection fraction and BNP levels >502 ng/ml were isolated as risk factors for overall mortality. Multivariate Cox regression analysis, including the known factors influencing NT-proBNP levels, identified NT-proBNP as an independent risk factor for mortality (OR = 3.079 (CI = 1.149-8.247), p = 0.025). Preoperative NT-proBNP levels >502 ng/ml were associated with increased ventilation time (p=0.005), longer intensive care unit stay (p=0.001), higher incidence of postoperative hemofiltration (p=0.001), use of intra-aortic balloon pump (p<0.001), and postoperative atrial fibrillation (p=0.031) CONCLUSION: Preoperative NT-proBNP levels >502 ng/ml predict mid-term mortality after isolated CABG and are associated with significantly higher hospital mortality and perioperative complications.
Full text:
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Index:
LILACS (Americas)
Main subject:
Peptide Fragments
/
Postoperative Complications
/
Preoperative Care
/
Coronary Artery Bypass
/
Hospital Mortality
/
Natriuretic Peptide, Brain
Type of study:
Etiology study
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Prognostic study
/
Risk factors
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
English
Journal:
Clinics
Journal subject:
Medicine
Year:
2010
Type:
Article
Affiliation country:
Austria
Institution/Affiliation country:
Innsbruck Medical University/AT
/
Vienna Medical University/AT
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