The NPPA/NPPB haplotype CACGC increased BNP and NT-proBNP plasma concentrations by 44% and 94%, respectively, compared to the reference haplotype TATAT in patients undergoing non-cardiac surgery.
Cohort (n=427)
Do NPPA/NPPB haplotypes impact BNP and NT-proBNP plasma levels in patients undergoing non-cardiac surgery?
Genetic variation in the NPPA/NPPB locus significantly impacts baseline BNP and NT-proBNP levels, suggesting genetic information could refine perioperative risk stratification thresholds.
Plasma concentrations of natriuretic peptides (NP) contribute to risk stratification and management of patients undergoing non-cardiac surgery. However, genetically determined variability in the levels of these biomarkers has been described previously. In the perioperative setting, genetic contribution to NP plasma level variability has not yet been determined. A cohort of 427 patients presenting for non-cardiac surgery was genotyped for single-nucleotide polymorphisms (SNPs) from the NPPA/NPPB locus. Haplotype population frequencies were estimated and adjusted haplotype trait associations for brain natriuretic peptide (BNP) and amino-terminal pro natriuretic peptide (NT-proBNP) were calculated. Five SNPs were included in the analysis. Compared to the reference haplotype TATAT (rs198358, rs5068, rs632793, rs198389, rs6676300), haplotype CACGC, with an estimated frequency of 4%, showed elevated BNP and NT-proBNP plasma concentrations by 44% and 94%, respectively. Haplotype CGCGC, with an estimated frequency of 9%, lowered NT-proBNP concentrations by 28%. ASA classification status III and IV, as well as coronary artery disease, were the strongest predictors of increased NP plasma levels. Inclusion of genetic information might improve perioperative risk stratification of patients based on adjusted thresholds of NP plasma levels.
Hahn et al. (Tue,) conducted a cohort in Patients presenting for non-cardiac surgery (n=427). NPPA/NPPB haplotypes vs. Reference haplotype TATAT was evaluated on BNP and NT-proBNP plasma concentrations. The NPPA/NPPB haplotype CACGC increased BNP and NT-proBNP plasma concentrations by 44% and 94%, respectively, compared to the reference haplotype TATAT in patients undergoing non-cardiac surgery.