Is perioperative pro-B-type natriuretic peptide a good tool to evaluate surgical risk in cardiac surgery?
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KeywordsRenal Failure Cardiac Surgery Risk Score Natriuretic Peptide Cardiac Failure
Predicting major adverse events and death in patients undergoing cardiac surgery is based on clinical risk scores such as Euroscore. This score has a moderate power for discriminating morbidity. Natriuretic peptides are well-established biomarkers in numerous clinical settings, prognostic, diagnostic and treatment of cardiac failure. In cardiac surgical patients the role of natriuretic peptides as risk markers is less well delineated.
To assess the utility of natriuretic peptides as risk markers in cardiac surgery
This study is a prospective longitudinal study of consecutive 135 patients undergoing on-pump cardiac surgery between 2012 and 2013. We evaluated preoperative euroSCORE II, preoperative and 24 h postoperative pro-BNP. The endpoints were: heart failure, renal failure, all-cause mortality at 12 months. Independent sample t-Test were performed.
One hundred thirty-five patients were available for analysis. the mean EuroSCORE II was 2,49%. Fourteen patients (10%) experienced postoperative heart failure and 30 patients (22%) renal failure. Within 12 months after surgery, six patients died. The "t" test showed significant augmentation of preoperative and postoperative pro-BNP in relation to heart and kidney failure.
Increased perioperative pro-BNP concentrations are associated with more incidence of postoperative heart failure and renal insufficiency. Elevated preoperative pro-BNP is not correlated with mortality. Postoperative pro-BNP adds little to the value of preoperative pro-BNP measurement alone.
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