Combined Examination of Plasma Levels of TnT and NT-proBNP for Predicting the Risk of Peri-operative Cardiovascular Events in Elder Coronary Artery Disease Patients With Non-cardiac Surgery / 中国循环杂志

ABSTRACT

Objective: To investigate the combined examination of plasma levels of troponin T (TnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) for predicting the risk of peri-operative cardiovascular events in elder coronary artery disease (CAD) patients with non-cardiac surgery. Methods: A total of 200 patients from (60-82) years of age with elective non-cardiac surgery were enrolled. The patients were divided into 2 groups CAD group,n=118 and Non-CAD group,n=82. Plasma levels of TnT and NT-proBNP were examined at 1 day before and 2 days after the operation respectively. The cardiovascular events were recorded in both groups and the best cut-off values for TnT and NT-proBNP in risk prediction were evaluated by receiver operating characteristic (ROC) analysis. Results:①CAD group had the higher levels of post-operative TnT and NT-proBNP than pre-operative; both TnT and NT-proBNP levels were higher in CAD group than those in Non-CAD group at the same time points, allP<0.05.②The total cardiovascular events in CAD group was higher than those in non-CAD group (χ2=5.85,P=0.016) and the individual event was similar between 2 groups.③In CAD group, the best cut-off value for pre-operative TnT in predicting peri-operative cardiovascular events was 18.5 ng/L with the sensitivity at 72% and speciifcity at 69.6%; for NT-proBNP was 98.0 pg/ml with the sensitivity at 90.8% and speciifcity at 74.6%.④The patients with the higher level of pre-operative TnT had the increased risk of total cardiovascular events than those with normal TnT (χ2=4.56,P=0.043), and the same as NT-proBNP (χ2=4.08, P=0.036). Likewise, the patients with higher levels of both pre-operative TnT and NT-proBNP had the increased risk of total cardiovascular events than those with normal TnT and NT-proBNP (χ2=13.32,P=0.000). Conclusion:Either plasma levels of TnT or NT-proBNP could be used as the biomarker for predicting the risk of peri-operative cardiovascular events in elder CAD patients with non-cardiac surgery, the combined examination would have the better predictive value.