The utility of B-type natriuretic peptide in predicting postoperative cardiac events and mortality in patients undergoing major emergency non-cardiac surgery

Brian Cuthbertson, G. Card, Bernard Lewis Croal, Jane McNeilly, Graham Scott Hillis

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

B-type natriuretic peptide (BNP) levels predict cardiovascular risk in several settings. We hypothesised that they would identify individuals at increased risk of complications and mortality following major emergency non-cardiac surgery. Forty patients were studied with a primary end-point of a new postoperative cardiac event, and/or development of significant ECG changes, and/or cardiac death. The main secondary outcome was all-cause mortality at 6 months. Pre-operative BNP levels were higher in 11 patients who suffered a new postoperative cardiac event (p = 0.001) and predicted this outcome with an area under the receiver operating characteristic curve of 0.85 (CI = 0.72-0.98, p = 0.001). A pre-operative BNP value > 170 pg.ml(-1) has a sensitivity of 82% and a specificity of 79% for the primary end-point. In this small study, pre-operative BNP levels identify patients undergoing major emergency non-cardiac surgery who are at increased risk of early postoperative cardiac events. Larger studies are required to confirm these data.

Original languageEnglish
Pages (from-to)875-881
Number of pages7
JournalAnaesthesia
Volume62
Issue number9
Early online date9 Aug 2007
DOIs
Publication statusPublished - Sep 2007

Keywords

  • high-risk patients
  • myocardial-infarction
  • troponin-i
  • diastolic dysfunction
  • vascular-surgery
  • prognostic value
  • intensive-care
  • heart-failure
  • marker
  • index

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