Association of Plasma N-Terminal Pro-B-Type Natriuretic Peptide With Postoperative Cardiac Events in Patients Undergoing Surgery for Abdominal Aortic Aneurysm or Leg Bypass

• Published in: The American journal of cardiology 2006-07, Vol.98 (1), p.111-115
• Main Authors: Feringa, Harm H.H., Bax, Jeroen J., Elhendy, Abdou, de Jonge, Robert, Lindemans, Jan, Schouten, Olaf, van den Meiracker, Anton H., Boersma, Eric, Schinkel, Arend F.L., Kertai, Miklos D., van Sambeek, Marc R.H.M., Poldermans, Don
• Format: Article
• Language: English
• Subjects: Analysis of Variance; Aneurysms; Aortic Aneurysm, Abdominal - blood; Aortic Aneurysm, Abdominal - surgery; Biological and medical sciences; Biomarkers - blood; Blood and lymphatic vessels; Cardiology. Vascular system; Diseases of the aorta; Female; Heart Diseases - blood; Heart Diseases - complications; Humans; Leg - blood supply; Leg - surgery; Logistic Models; Male; Medical sciences; Middle Aged; Natriuretic Peptide, Brain - blood; Peptide Fragments - blood; Peptides; Plasma; Postoperative Complications - blood; Postoperative Complications - etiology; Postoperative Complications - prevention & control; Prognosis; Prospective Studies; Protein Precursors - blood; Risk assessment; ROC Curve; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Vascular surgery; Vascular Surgical Procedures - adverse effects
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2006.01.058

Postoperative cardiac events are related to myocardial ischemia and reduced left ventricular function. The utility of N-terminal–pro-B-type natriuretic peptide (NT–pro-BNP) for preoperative cardiac risk evaluation has not been evaluated. The objective of this study was to assess whether plasma NT–pro-BNP predicts postoperative cardiac events in patients who undergo major vascular surgery in addition to clinical and dobutamine stress echocardiographic data. One hundred seventy consecutive patients scheduled for major noncardiac vascular surgery were prospectively evaluated by dobutamine stress echocardiographic and NT–pro-BNP measurements. Multivariable logistic regression analysis was performed to evaluate the predictors of cardiac death and nonfatal myocardial infarction during a follow-up of 30-days. Receiver-operating characteristic analysis was performed to determine the optimal cut-off value of NT–pro-BNP to predict outcome. Patients’ mean age was 59 ± 13 years, and 71% were men. The median NT–pro-BNP level was 110 pg/ml (interquartile range 42 to 389). Cardiac events occurred in 2 of 144 patients (1.4%) with NT–pro-BNP