|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.|
|PMID: 21215559 Owner: NLM Status: MEDLINE|
|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.
|Nikolaus Duschek; Edda Skrinjar; Thomas Waldhör; Christian Vutuc; Gerhard Daniel; Wolfgang Hübl; Afshin Assadian|
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|Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't Date: 2011-01-07|
|Title: Journal of vascular surgery Volume: 53 ISSN: 1097-6809 ISO Abbreviation: J. Vasc. Surg. Publication Date: 2011 May|
|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|
|Languages: eng Pagination: 1242-50 Citation Subset: IM|
|Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.|
|Department of General and Vascular Surgery, Wilhelminenspital, Vienna, Austria. firstname.lastname@example.org|
|APA/MLA Format Download EndNote Download BibTex|
Aged, 80 and over
Biological Markers / blood
Carotid Artery, Internal / surgery*, ultrasonography
Carotid Stenosis / blood, mortality, surgery*, ultrasonography
Endarterectomy, Carotid / adverse effects, mortality*
Natriuretic Peptide, Brain / blood*
Peptide Fragments / blood*
Predictive Value of Tests
Proportional Hazards Models
Survivors / statistics & numerical data*
Ultrasonography, Doppler, Duplex
|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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