Key result
NT-proBNP measurements improved risk prediction for long-term mortality on top of EuroSCORE II in cardiac surgical patients (net reclassification index 0.39; 95% CI 0.14-0.64; p=0.003).
Why the study?
Does the addition of NT-proBNP and hs-TnT to EuroSCORE II improve risk prediction for long-term mortality in cardiac surgical patients?
Cohort (n=730)
Does the addition of NT-proBNP and hs-TnT to EuroSCORE II improve risk prediction for long-term mortality in cardiac surgical patients?
Answers are grounded in this paper and cite their sources.
NT-proBNP measurements, but not hs-TnT, improve and simplify risk prediction for long-term mortality in cardiac surgical patients compared to EuroSCORE II alone.
BACKGROUND: European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) is used for risk stratification before cardiac surgery, but whether N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (hs-TnT) may add prognostic information to EuroSCORE II is not known. METHODS: Preoperative (n=640) and postoperative (n=629) blood samples were available from cardiac surgical patients with 961-day follow-up (FINNAKI Heart study; cohort #1). The accuracy of a parsimonious risk model with NT-proBNP measurements was also tested in 90 patients with respiratory failure after cardiac surgery (FINNALI study; cohort #2). RESULTS: NT-proBNP] 1.33 [95% CI 1.08-1.64]), p=0.008 and reclassified patients on top of EuroSCORE II (net reclassification index 0.39 [95% CI 0.14-0.64], p=0.003). Pre- and postoperative NT-proBNP concentrations were closely correlated (rho=0.80, p<0.001) and postoperative NT-proBNP concentrations were also associated with long-term mortality after adjustment for EuroSCORE II. A parsimonious risk model that included age, creatinine clearance, chronic pulmonary disease, and NT-proBNP measurements provided comparable prognostic accuracy as EuroSCORE II in cohort #1 and #2 for risk of long-term mortality. hs-TnT measurements did not add to NT-proBNP measurements CONCLUSION: NT-proBNP measurements could improve and simplify risk prediction in cardiac surgical patients.
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Brynildsen et al. (2018) conducted a cohort in Cardiac surgical patients (n=730). NT-proBNP and hs-TnT measurements vs. EuroSCORE II was evaluated on Long-term mortality (1.33, 95% CI 1.08-1.64, p=0.008). NT-proBNP measurements improved risk prediction for long-term mortality on top of EuroSCORE II in cardiac surgical patients (net reclassification index 0.39; 95% CI 0.14-0.64; p=0.003).
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