N-terminal pro-B-type natriuretic peptide is an independent predictor of all-cause mortality and MACE after major vascular surgery in medium-term follow-up

Sriram Rajagopalan, Bernard L Croal, Paul Bachoo, Graham Hillis, Julie Brittenden

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

OBJECTIVE: Recent interest has focussed on the role of biomarkers to predict outcome in patients undergoing major vascular surgery. We wished to determine if pre- and postoperative N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) levels could predict all-cause mortality (ACM; primary aim) and major adverse cardiac event (MACE) (secondary aim) in the medium-term follow-up in patients who have undergone elective major vascular surgery. METHOD: Patients who underwent major elective vascular surgery (n = 136) were followed up for up to 2 years. ACM and first MACE episode were identified from the case notes and the patient management system database of the hospital intranet. RESULTS: One patient was lost to follow-up. In the mean follow-up of 654 days, 27 (20%) died and 23 (17%) patients suffered a MACE. Receiver operator curve (ROC) analysis showed that a pre-operative NT-pro-BNP level with a cut-off of 359 pg ml(-1) had a sensitivity and specificity of 73% each (area under the curve (AUC) 80%, p < 0.001) in predicting ACM and sensitivity of 74% and specificity of 71% (AUC 75%, p < 0.001) to detect a MACE. The overall 2-year survival rate was 84%, 93% in the <359 pg ml(-1) group and 68% in the ≥359 pg ml(-1) group (p < 0.001). Following multivariate analysis, pre-operative NT-pro-BNP at a value of ≥359 pg ml(-1) remained an independent predictor of ACM (odds ratio 3.6 (confidence interval (CI): 1.6-8.1), p = 0.002) Postoperative NT-pro-BNP was a predictor of mortality but not a MACE. CONCLUSION: This study has shown that pre-operative NT-pro-BNP is an independent predictor of ACM and MACE on medium-term follow-up.
Original languageEnglish
Pages (from-to)657-662
Number of pages6
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume41
Issue number5
Early online date16 Feb 2011
DOIs
Publication statusPublished - May 2011

Fingerprint

Brain Natriuretic Peptide
Blood Vessels
Mortality
Area Under Curve
Database Management Systems
Sensitivity and Specificity
Computer Communication Networks
Lost to Follow-Up
Multivariate Analysis
Survival Rate
Biomarkers
Odds Ratio
Confidence Intervals

Keywords

  • bnp
  • N-terminal pro-B-type natriuretic peptide
  • all-cause mortality
  • major adverse cardiac event
  • medim-term outcome

Cite this

N-terminal pro-B-type natriuretic peptide is an independent predictor of all-cause mortality and MACE after major vascular surgery in medium-term follow-up. / Rajagopalan, Sriram; Croal, Bernard L; Bachoo, Paul; Hillis, Graham; Brittenden, Julie.

In: European Journal of Vascular and Endovascular Surgery, Vol. 41, No. 5, 05.2011, p. 657-662.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE: Recent interest has focussed on the role of biomarkers to predict outcome in patients undergoing major vascular surgery. We wished to determine if pre- and postoperative N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) levels could predict all-cause mortality (ACM; primary aim) and major adverse cardiac event (MACE) (secondary aim) in the medium-term follow-up in patients who have undergone elective major vascular surgery. METHOD: Patients who underwent major elective vascular surgery (n = 136) were followed up for up to 2 years. ACM and first MACE episode were identified from the case notes and the patient management system database of the hospital intranet. RESULTS: One patient was lost to follow-up. In the mean follow-up of 654 days, 27 (20{\%}) died and 23 (17{\%}) patients suffered a MACE. Receiver operator curve (ROC) analysis showed that a pre-operative NT-pro-BNP level with a cut-off of 359 pg ml(-1) had a sensitivity and specificity of 73{\%} each (area under the curve (AUC) 80{\%}, p < 0.001) in predicting ACM and sensitivity of 74{\%} and specificity of 71{\%} (AUC 75{\%}, p < 0.001) to detect a MACE. The overall 2-year survival rate was 84{\%}, 93{\%} in the <359 pg ml(-1) group and 68{\%} in the ≥359 pg ml(-1) group (p < 0.001). Following multivariate analysis, pre-operative NT-pro-BNP at a value of ≥359 pg ml(-1) remained an independent predictor of ACM (odds ratio 3.6 (confidence interval (CI): 1.6-8.1), p = 0.002) Postoperative NT-pro-BNP was a predictor of mortality but not a MACE. CONCLUSION: This study has shown that pre-operative NT-pro-BNP is an independent predictor of ACM and MACE on medium-term follow-up.",
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T1 - N-terminal pro-B-type natriuretic peptide is an independent predictor of all-cause mortality and MACE after major vascular surgery in medium-term follow-up

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AU - Croal, Bernard L

AU - Bachoo, Paul

AU - Hillis, Graham

AU - Brittenden, Julie

PY - 2011/5

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AB - OBJECTIVE: Recent interest has focussed on the role of biomarkers to predict outcome in patients undergoing major vascular surgery. We wished to determine if pre- and postoperative N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) levels could predict all-cause mortality (ACM; primary aim) and major adverse cardiac event (MACE) (secondary aim) in the medium-term follow-up in patients who have undergone elective major vascular surgery. METHOD: Patients who underwent major elective vascular surgery (n = 136) were followed up for up to 2 years. ACM and first MACE episode were identified from the case notes and the patient management system database of the hospital intranet. RESULTS: One patient was lost to follow-up. In the mean follow-up of 654 days, 27 (20%) died and 23 (17%) patients suffered a MACE. Receiver operator curve (ROC) analysis showed that a pre-operative NT-pro-BNP level with a cut-off of 359 pg ml(-1) had a sensitivity and specificity of 73% each (area under the curve (AUC) 80%, p < 0.001) in predicting ACM and sensitivity of 74% and specificity of 71% (AUC 75%, p < 0.001) to detect a MACE. The overall 2-year survival rate was 84%, 93% in the <359 pg ml(-1) group and 68% in the ≥359 pg ml(-1) group (p < 0.001). Following multivariate analysis, pre-operative NT-pro-BNP at a value of ≥359 pg ml(-1) remained an independent predictor of ACM (odds ratio 3.6 (confidence interval (CI): 1.6-8.1), p = 0.002) Postoperative NT-pro-BNP was a predictor of mortality but not a MACE. CONCLUSION: This study has shown that pre-operative NT-pro-BNP is an independent predictor of ACM and MACE on medium-term follow-up.

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KW - N-terminal pro-B-type natriuretic peptide

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KW - major adverse cardiac event

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DO - 10.1016/j.ejvs.2010.12.017

M3 - Article

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JO - European Journal of Vascular and Endovascular Surgery

JF - European Journal of Vascular and Endovascular Surgery

SN - 1078-5884

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