Document Detail


N-terminal pro B-type natriuretic peptide (NT pro-BNP) is a predictor of long-term survival in male patients of 75 years and older with high-grade asymptomatic internal carotid artery stenosis.
MedLine Citation:
PMID:  21215559     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Carotid endarterectomy (CEA) is commonly performed for asymptomatic high-grade internal carotid artery (ICA) stenosis to prevent stroke. However, despite advancing age of the society, for patients older than 75 years, there is no recommendation by the European guidelines for CEA, as this age group might not benefit from this intervention due to a limited life expectancy.
OBJECTIVE: We assessed N-terminal pro B-type natriuretic peptide (NT pro-BNP) as a predictive marker for long-term survival in this particular patient population in order to stratify patients for an improved surgical outcome.
METHODS: In a nonrandomized single-center clinical trial, we prospectively studied mortality rates of 205 consecutive patients (80 women, 125 men; mean age, 75 ± 10 years) with asymptomatic high-grade ICA stenosis in relation to preoperative plasma NT pro-BNP levels. We estimated cumulative survival over 5 years by Kaplan-Meier curves and established a proportional hazard-model by Cox regression.
RESULTS: In male patients, higher levels of preoperative NT pro-BNP levels were associated with a significantly increased long-term mortality. Those 75 years or older had the same survival rate as younger patients, if NT pro-BNP levels were low, making them thus eligible for CEA.
CONCLUSIONS: The results of our study suggest that preoperative plasma levels of NT pro-BNP are a valuable tool for the stratification of male patients. Male patients older than 75 years with low levels of NT pro-BNP should be referred for carotid revascularization, as they will most likely enjoy the benefit of surgery.
Authors:
Nikolaus Duschek; Edda Skrinjar; Thomas Waldhör; Christian Vutuc; Gerhard Daniel; Wolfgang Hübl; Afshin Assadian
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-01-07
Journal Detail:
Title:  Journal of vascular surgery     Volume:  53     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-17     Completed Date:  2011-07-18     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1242-50     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of General and Vascular Surgery, Wilhelminenspital, Vienna, Austria. nduschek@me.com
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aged, 80 and over
Asymptomatic Diseases
Austria
Biological Markers / blood
Carotid Artery, Internal / surgery*,  ultrasonography
Carotid Stenosis / blood,  mortality,  surgery*,  ultrasonography
Endarterectomy, Carotid / adverse effects,  mortality*
Female
Humans
Kaplan-Meier Estimate
Male
Natriuretic Peptide, Brain / blood*
Patient Selection
Peptide Fragments / blood*
Predictive Value of Tests
Proportional Hazards Models
Prospective Studies
Risk Assessment
Risk Factors
Sex Factors
Survival Rate
Survivors / statistics & numerical data*
Time Factors
Treatment Outcome
Ultrasonography, Doppler, Duplex
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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