N-Terminal Pro-Brain Natriuretic Peptide and Angiotensin-Converting Enzyme-2 Levels and Their Association With Postoperative Cardiac Complications After Emergency Orthopedic Surgery

The prognostic usefulness of the cardiac biomarkers N-terminal pro-brain natriuretic peptide (NT-proBNP) and angiotensin-converting enzyme 2 (ACE-2), in predicting adverse cardiac outcomes after orthopedic surgery is not well studied. The aim of our study was to determine the usefulness of periopera...

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Bibliographic Details
Published in:The American journal of cardiology 2012-05, Vol.109 (9), p.1365-1373
Main Authors: Chong, Carol P., MD, Lim, Wen Kwang, MD, Velkoska, Elena, PhD, van Gaal, William J., MD, Ryan, Julie E., BApp Sci, FAACB, Savige, Judy, PhD, Burrell, Louise M., MD
Format: Article
Language:English
Subjects:
ACE inhibitors
Aged
Aged, 80 and over
Biomarkers
Biomarkers - blood
Cardiology
Cardiovascular
Clinical outcomes
Female
Follow-Up Studies
Heart Diseases - blood
Heart Diseases - diagnosis
Heart Diseases - etiology
Humans
Male
Middle Aged
Multivariate analysis
Natriuretic Peptide, Brain - blood
Orthopedic Procedures - adverse effects
Peptide Fragments - blood
Peptides
Peptidyl-Dipeptidase A - blood
Postoperative Complications
Postoperative Period
Predictive Value of Tests
Prognosis
Protein Precursors
Retrospective Studies
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Summary:The prognostic usefulness of the cardiac biomarkers N-terminal pro-brain natriuretic peptide (NT-proBNP) and angiotensin-converting enzyme 2 (ACE-2), in predicting adverse cardiac outcomes after orthopedic surgery is not well studied. The aim of our study was to determine the usefulness of perioperative NT-proBNP and ACE-2 for predicting cardiac events after emergency orthopedic surgery. The perioperative NT-proBNP and ACE-2 levels were determined in 187 consecutive patients aged >60 years who underwent orthopedic surgery with 1 year of follow-up for any cardiac complications (defined as acute myocardial infarction, congestive cardiac failure, atrial fibrillation, or major arrhythmia) and death. Of the 187 patients, 20 (10.7%) sustained an in-hospital postoperative cardiac complication. The total all-cause in-hospital and 1-year mortality rate was 1.6% (3 of 187) and 8.6% (16 of 187), respectively. The median preoperative and postoperative NT-proBNP level was greater in patients who sustained an in-hospital cardiac event than in those who had not (386 vs 2,273 pg/ml, p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2011.12.032