Influence of preoperative serum N-terminal pro-brain type natriuretic peptide on the postoperative outcome and survival rates of coronary artery bypass patients
BACKGROUND: The N-terminal fragment of pro-brain type natriuretic peptide (NT-proBNP) is an established biomarker for cardiac failure. OBJECTIVE: To determine the influence of preoperative serum NT-proBNP on postoperative outcome and mid-term survival in patients undergoing coronary artery bypass gr...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier España
2010-01-01
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| Series: | Clinics |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200004 |
| _version_ | 1811317378642870272 |
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| author | Thomas Schachner Dominik Wiedemann Hannes Fetz Guenther Laufer Alfred Kocher Nikolaos Bonaros |
| author_facet | Thomas Schachner Dominik Wiedemann Hannes Fetz Guenther Laufer Alfred Kocher Nikolaos Bonaros |
| author_sort | Thomas Schachner |
| collection | DOAJ |
| description | BACKGROUND: The N-terminal fragment of pro-brain type natriuretic peptide (NT-proBNP) is an established biomarker for cardiac failure. OBJECTIVE: To determine the influence of preoperative serum NT-proBNP on postoperative outcome and mid-term survival in patients undergoing coronary artery bypass grafting (CABG). METHODS: In 819 patients undergoing isolated CABG surgery preoperative serum NT-proBNP levels were measured. NT-proBNP was correlated with various postoperative outcome parameters and survival rate after a median follow-up time of 18 (0.5-44) months. Risk factors of mortality were identified using χ2, Mann-Whitney test, and Cox regression. RESULTS: NT-proBNP levels >430 ng/ml and >502 ng/ml predicted hospital and overall mortality (p<0.05), with an incidence of 1.6% and 4%, respectively. Kaplan-Meier analysis revealed decreased survival rates in patients with NT-proBNP >502 ng/ml (p=0.001). Age, preoperative serum creatinine, diabetes, chronic obstructive pulmonary disease, low left ventricular ejection fraction and BNP levels >502 ng/ml were isolated as risk factors for overall mortality. Multivariate Cox regression analysis, including the known factors influencing NT-proBNP levels, identified NT-proBNP as an independent risk factor for mortality (OR = 3.079 (CI = 1.149-8.247), p = 0.025). Preoperative NT-proBNP levels >502 ng/ml were associated with increased ventilation time (p=0.005), longer intensive care unit stay (p=0.001), higher incidence of postoperative hemofiltration (p=0.001), use of intra-aortic balloon pump (p<0.001), and postoperative atrial fibrillation (p=0.031) CONCLUSION: Preoperative NT-proBNP levels >502 ng/ml predict mid-term mortality after isolated CABG and are associated with significantly higher hospital mortality and perioperative complications. |
| first_indexed | 2024-04-13T12:06:59Z |
| format | Article |
| id | doaj.art-4135f05d4a004ab787fd9bcdcd6d332c |
| institution | Directory Open Access Journal |
| issn | 1807-5932 1980-5322 |
| language | English |
| last_indexed | 2024-04-13T12:06:59Z |
| publishDate | 2010-01-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Clinics |
| spelling | doaj.art-4135f05d4a004ab787fd9bcdcd6d332c2022-12-22T02:47:37ZengElsevier EspañaClinics1807-59321980-53222010-01-0165121239124510.1590/S1807-59322010001200004Influence of preoperative serum N-terminal pro-brain type natriuretic peptide on the postoperative outcome and survival rates of coronary artery bypass patientsThomas SchachnerDominik WiedemannHannes FetzGuenther LauferAlfred KocherNikolaos BonarosBACKGROUND: The N-terminal fragment of pro-brain type natriuretic peptide (NT-proBNP) is an established biomarker for cardiac failure. OBJECTIVE: To determine the influence of preoperative serum NT-proBNP on postoperative outcome and mid-term survival in patients undergoing coronary artery bypass grafting (CABG). METHODS: In 819 patients undergoing isolated CABG surgery preoperative serum NT-proBNP levels were measured. NT-proBNP was correlated with various postoperative outcome parameters and survival rate after a median follow-up time of 18 (0.5-44) months. Risk factors of mortality were identified using χ2, Mann-Whitney test, and Cox regression. RESULTS: NT-proBNP levels >430 ng/ml and >502 ng/ml predicted hospital and overall mortality (p<0.05), with an incidence of 1.6% and 4%, respectively. Kaplan-Meier analysis revealed decreased survival rates in patients with NT-proBNP >502 ng/ml (p=0.001). Age, preoperative serum creatinine, diabetes, chronic obstructive pulmonary disease, low left ventricular ejection fraction and BNP levels >502 ng/ml were isolated as risk factors for overall mortality. Multivariate Cox regression analysis, including the known factors influencing NT-proBNP levels, identified NT-proBNP as an independent risk factor for mortality (OR = 3.079 (CI = 1.149-8.247), p = 0.025). Preoperative NT-proBNP levels >502 ng/ml were associated with increased ventilation time (p=0.005), longer intensive care unit stay (p=0.001), higher incidence of postoperative hemofiltration (p=0.001), use of intra-aortic balloon pump (p<0.001), and postoperative atrial fibrillation (p=0.031) CONCLUSION: Preoperative NT-proBNP levels >502 ng/ml predict mid-term mortality after isolated CABG and are associated with significantly higher hospital mortality and perioperative complications.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200004Brain type natriuretic peptideBNPNT-proBNPCABGCoronary artery disease |
| spellingShingle | Thomas Schachner Dominik Wiedemann Hannes Fetz Guenther Laufer Alfred Kocher Nikolaos Bonaros Influence of preoperative serum N-terminal pro-brain type natriuretic peptide on the postoperative outcome and survival rates of coronary artery bypass patients Clinics Brain type natriuretic peptide BNP NT-proBNP CABG Coronary artery disease |
| title | Influence of preoperative serum N-terminal pro-brain type natriuretic peptide on the postoperative outcome and survival rates of coronary artery bypass patients |
| title_full | Influence of preoperative serum N-terminal pro-brain type natriuretic peptide on the postoperative outcome and survival rates of coronary artery bypass patients |
| title_fullStr | Influence of preoperative serum N-terminal pro-brain type natriuretic peptide on the postoperative outcome and survival rates of coronary artery bypass patients |
| title_full_unstemmed | Influence of preoperative serum N-terminal pro-brain type natriuretic peptide on the postoperative outcome and survival rates of coronary artery bypass patients |
| title_short | Influence of preoperative serum N-terminal pro-brain type natriuretic peptide on the postoperative outcome and survival rates of coronary artery bypass patients |
| title_sort | influence of preoperative serum n terminal pro brain type natriuretic peptide on the postoperative outcome and survival rates of coronary artery bypass patients |
| topic | Brain type natriuretic peptide BNP NT-proBNP CABG Coronary artery disease |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200004 |
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