Utility of B-type natriuretic peptide in predicting the level of peri and post-operative cardiovascular support required after coronary artery bypass grafting

Objective: To determine whether preoperative plasma levels of B-type natriuretic peptide would allow for the prediction of perioperative and early postoperative cardiovascular support requirements and hospital bed usage after coronary artery surgery.

Design: A prospective observational cohort study.

Setting: A tertiary referral cardiothoracic unit in Scotland.

Patients. Forty-six consecutive patients undergoing coronary artery surgery.

Interventions: None.

Measurements and Main Results: Demographics, clinical details, preoperative and postoperative B-type natriuretic peptide levels, type of surgery, postoperative complications, postoperative cardiac troponin I levels, and duration of stay were collected. Preoperative plasma levels of B-type natriuretic peptide are significantly higher in patients who require perioperative inotropic or mechanical cardiovascular support, compared with those who do not. They are also higher in those who require postoperative inotropic or mechanical cardiovascular support, compared with those who do not. B-type natriuretic peptide levels are higher in those who require increased intensive care unit stay but not a prolonged hospital stay.

Conclusions: Preoperative plasma levels of B-type natriuretic peptide levels may be useful in predicting the need for increased peri and postoperative cardiovascular support and a more prolonged stays in intensive care following coronary artery surgery.