Cardiac risk stratification in elective non-cardiac surgery: role of NT-proBNP

Int Angiol. 2011 Jun;30(3):242-6.

Abstract

Aim: The aim of the study was to investigate the utility of NT-proBNP measurement for the stratification of presurgical cardiac risk.

Methods: Cardiac risk before elective non-cardiac surgery was evaluated in 82 consecutive patients. From each patient a venous blood sample was drawn to determinate NT-proBNP levels. Patients were followed up over three months in order to detect the occurrence of cardiac adverse events.

Results: NT-proBNP was positively correlated (P<0.0001) with age, days of hospitalization (P=0.001) and ASA class (P=0.001). High surgical risk (P<0.0001), diabetes (P=0.004), dyslipidemia (P=0.006) and elevated levels of NT-proBNP (P<0.0001) were significantly correlated with events. Using a logistic regression analysis we found an independent association between pre-operative elevated NT-proBNP and postoperative cardiac events (OR 1.2, 95% CI 1.0-1.4, P=0.01).

Conclusion: Measuring NT-proBNP before non cardiac surgery in clinical practice could be useful to better stratify patients' risk.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Biomarkers / blood
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / etiology*
  • Chi-Square Distribution
  • Elective Surgical Procedures
  • Female
  • Humans
  • Italy
  • Logistic Models
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood*
  • Odds Ratio
  • Peptide Fragments / blood*
  • Predictive Value of Tests
  • Preoperative Period
  • Risk Assessment
  • Risk Factors
  • Surgical Procedures, Operative / adverse effects*
  • Time Factors
  • Treatment Outcome
  • Up-Regulation

Substances

  • Biomarkers
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain