Document Detail


Plasma N-terminal prohormone brain natriuretic peptide as a marker for postoperative cardiac events in high-risk patients undergoing noncardiac surgery.
MedLine Citation:
PMID:  19576335     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study considered if N-terminal prohormone brain natriuretic peptide (NT-proBNP) is associated with increased risk for postoperative cardiac events in high-risk patients undergoing noncardiac surgery. In addition, this report describes how levels of NT-proBNP are affected by noncardiac surgery. The study design was a prospective cohort study that enrolled 83 patients age > or =50 years with > or =1 risk factor for coronary artery disease having intermediate or high-risk noncardiac surgery. NT-proBNP levels were measured preoperatively and on postoperative days 1 and 3. During the month following surgery, 25 patients (33%) had a combined 37 postoperative cardiac events including 15 episodes of heart failure (20%), 12 episodes of new dysrhythmia (16%), 7 myocardial infarctions (9%), and 3 cardiac arrests (4%). Preoperative NT-proBNP level > or =457 pg/ml was significantly associated with occurrence of a postoperative cardiac event (odds ratio 10.5, 95% confidence interval 1.9 to 56.6, p = 0.006). After surgery, 64 of 72 patients (89%) had an increase in NT-proBNP from their preoperative level. In conclusion, this study determined there was a significant association between elevated preoperative NT-proBNP and occurrence of a postoperative cardiac event. In addition, increased NT-proBNP after noncardiac surgery is not uncommon even in the absence of clinically identifiable heart failure.
Authors:
Robert Clark Schutt; Cihan Cevik; Michael P Phy
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-05-13
Journal Detail:
Title:  The American journal of cardiology     Volume:  104     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-06     Completed Date:  2009-07-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  137-40     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA. rob.schutt@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Biological Markers / blood
Cohort Studies
Confidence Intervals
Coronary Artery Disease / blood*,  etiology
Female
Humans
Male
Natriuretic Peptide, Brain / blood*
Odds Ratio
Peptide Fragments / blood*
Postoperative Complications / blood*,  etiology
Prognosis
Prospective Studies
ROC Curve
Risk Assessment
Risk Factors
Sensitivity and Specificity
Time Factors
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain

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