Brain natriuretic peptide a predictive marker in cardiac surgery

• Published in: Interactive cardiovascular and thoracic surgery 2009-10, Vol.9 (4), p.662-666
• Main Authors: Attaran, Saina, Sherwood, Roy, Desai, Jatin, Langworthy, Rachel, Mhandu, Peter, John, Lindsay, El-Gamel, Ahmed
• Format: Article
• Language: English
• Subjects: Aged; Atrial Fibrillation - blood; Atrial Fibrillation - etiology; Biomarkers - blood; Cardiac Surgical Procedures - adverse effects; Cardiac Surgical Procedures - mortality; Cardiotonic Agents - therapeutic use; Comorbidity; Female; Health Status Indicators; Hospital Mortality; Humans; Kidney Diseases - blood; Kidney Diseases - etiology; Length of Stay; Male; Middle Aged; Natriuretic Peptide, Brain - blood; Predictive Value of Tests; Prospective Studies; Reproducibility of Results; Respiration, Artificial; Risk Assessment; Risk Factors; Surgical Wound Infection - blood; Surgical Wound Infection - etiology; Time Factors; Treatment Outcome; Up-Regulation
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1510/icvts.2008.189837

a Department of Cardiothoracic, King's College NHS Foundation Trust, London, UK b Department of Clinical Biochemistry, King's College NHS Foundation Trust, London, UK *Corresponding author. 46 Queen of Denmark Court, Finland Street, SE16 7TB London, UK. Tel.: [phone]; fax: [phone]. E-mail address : saina.attaran{at}kcl.ac.uk (S. Attaran). Background: BNP which stands for B-type natriuretic peptide is a cardiac neurohormone and is secreted in response to myocardial stress and causes natriuresis and vasodilatation. Studies have reported close correlation between a high concentration of BNP in blood and worse short-term and long-term prognosis following myocardial infarction and heart failure. In this study, we have tested its usefulness and predictive value in the outcome post cardiac surgery. Methods: Between March 2006 and June 2007, 141 patients, undergoing cardiac surgery, were enrolled in this study. Their BNP concentration was measured prior to the operation and their comorbidities were examined against their BNP levels. Postoperatively their outcome was closely monitored. Main clinical endpoints were atrial fibrillation (AF), inotrope use, renal impairment, early deaths and hospital stay. Results: Some preoperative comorbidities, such as renal impairment, peripheral vascular disease (PVD) and low ejection fraction (EF) were associated with higher BNP level. Statistically, EuroSCORE and Parsonnet score showed significant correlation with preoperative BNP concentration ( P