Key result
Elevated preoperative NT-pro-BNP levels in adult cardiac surgery patients were significantly associated with a higher need for postoperative inotropic support compared to those with low levels (86.7% vs 28.6%, p=0.006).
Why the study?
The relationship of preoperative NT-pro-BNP testing in routine cardiac surgery with clinical variables, surgical outcomes, complications, and EuroSCORE II in pediatric and adult patients remained to be defined.
Does preoperative NT-pro-BNP level correlate with clinical and perioperative variables in pediatric and adult cardiac surgery patients?
Cohort (n=48)
No
Does preoperative NT-pro-BNP level correlate with clinical and perioperative variables in pediatric and adult cardiac surgery patients?
Preoperative NT-pro-BNP levels correlate significantly with surgical risk scores, renal function, and the need for postoperative inotropic support in adult cardiac surgery patients.
Answers are grounded in this paper and cite their sources.
Elevated preoperative NT-pro-BNP was associated with greater postoperative inotropic support needs in adult cardiac surgery; leaves open its added value beyond existing risk scores.
Objective: We aimed to define the relationship of preoperative N-terminal-pro-brain type natriuretic peptide (NT-pro-BNP) testing in routine practice of cardiac surgery with clinical, perioperative variables, surgical outcomes and complications in pediatric and adult cardiac surgery patients. In addition, we assessed relationship of NT-pro-BNP with EuroSCORE II in adult patients undergoing cardiac surgery. Methods: A total of 48 patients who underwent cardiac surgery in our institution were enrolled into this retrospective observational cohort study. According to age aspects pediatric (PG, n=20) and adult (AG, n=28) group of patients were separately evaluated. Each group further was categorized into two subgroups (group 1 and 2) on the basis of cut-off points of NT-pro-BNP level (430 and 250pg/ml in adults and children, respectively). Preoperative NT-pro- BNP was obtained from patients. Statistical tests were conducted to reveal differences in clinical and perioperative variables among NT-pro-BNP groups and relationship of the assay with baseline clinical and operative parameters, as well as postoperative outcomes. Results: In adults undergoing cardiac surgery, statistically significant differences were found between groups with low and high levels of NT-pro-BNP by NYHA classes (I to III, p˂0.001), body mass index (BMI) values (mean (SD) -31.7(3.15) vs 25.9 (3.8) kg/cm2, p=0.017), estimated glomerular filtration rate (eGFR) (111.4 (26.4) vs 77.9 (22.4) ml/min/1.73m2, p=0.036), moderately impaired renal function (20% vs 72.7%, p=0.049), need for inotropes (28.6% vs 86.7%, p=0.006), and mean EuroSCORE II (0.81 (0.19) vs 1.7 (0.5), p=0.008). There was the positive significant correlation of NT-pro-BNP levels with EuroSCORE II, NYHA class, need for inotropes, renal function and left ventricular (LV) function categories, while its negative correlation was found with BMI, LV ejection fraction and eGFR parameters. In PG – NT-pro-BNP was negatively correlated with age, body surface area, LV end-diastolic and end-systolic dimensions. Conclusion: In adult patients undergoing cardiac surgery, preoperative NT-pro-BNP level correlated well with several baseline and clinical-operative parameters, including BMI, renal and LV function, NYHA class, need for inotropes support, and EuroSCORE II. Further studies are needed to define its exact diagnostic and prognostic significance in pediatric patients.
No takes yet. Share an insight, caveat, or question.
Akhmedova et al. (2020) conducted a cohort in Cardiac surgery (n=48). Preoperative NT-pro-BNP vs. Low NT-pro-BNP (<430 pg/ml in adults, <250 pg/ml in children) was evaluated on Need for inotropes in early postoperative period (adults) (p=0.006). Elevated preoperative NT-pro-BNP levels in adult cardiac surgery patients were significantly associated with a higher need for postoperative inotropic support compared to those with low levels (86.7% vs 28.6%, p=0.006).
Synapse has enriched 10 related papers. Consider them for comparative context: