The utility of B‐type natriuretic peptide in predicting postoperative cardiac events and mortality in patients undergoing major emergency non‐cardiac surgery

Summary B‐type natriuretic peptide (BNP) levels predict cardiovascular risk in several settings. We hypothesised that they would identify individuals at increased risk of complications and mortality following major emergency non‐cardiac surgery. Forty patients were studied with a primary end‐point o...

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Bibliographic Details
Published in:Anaesthesia 2007-09, Vol.62 (9), p.875-881
Main Authors: Cuthbertson, B. H., Card, G., Croal, B. L., McNeilly, J., Hillis, G. S.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biochemistry
Biological and medical sciences
Biomarkers - blood
Cardiovascular Diseases - blood
Clinical outcomes
Emergencies
Epidemiologic Methods
Female
Heart
Humans
Hypotheses
Male
Medical sciences
Middle Aged
Natriuretic Peptide, Brain - blood
Peptides
Postoperative Complications - blood
Preoperative Care - methods
Prognosis
Risk factors
Surgery
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Summary:Summary B‐type natriuretic peptide (BNP) levels predict cardiovascular risk in several settings. We hypothesised that they would identify individuals at increased risk of complications and mortality following major emergency non‐cardiac surgery. Forty patients were studied with a primary end‐point of a new postoperative cardiac event, and/or development of significant ECG changes, and/or cardiac death. The main secondary outcome was all‐cause mortality at 6 months. Pre‐operative BNP levels were higher in 11 patients who suffered a new postoperative cardiac event (p = 0.001) and predicted this outcome with an area under the receiver operating characteristic curve of 0.85 (CI = 0.72–0.98, p = 0.001). A pre‐operative BNP value > 170 pg.ml−1 has a sensitivity of 82% and a specificity of 79% for the primary end‐point. In this small study, pre‐operative BNP levels identify patients undergoing major emergency non‐cardiac surgery who are at increased risk of early postoperative cardiac events. Larger studies are required to confirm these data.
ISSN:0003-2409
1365-2044
DOI:10.1111/j.1365-2044.2007.05146.x