Key result
In patients undergoing off-pump coronary bypass, baseline B-type natriuretic peptide >100 pg/mL was associated with longer inotropic (43.8 vs 31.4 h, p=0.03) and ventilator support.
Observational (n=80)
Absolute Event Rate: 43.8% vs 31.4%
p-value: p=0.03
Baseline and postoperative B-type natriuretic peptide levels are significant predictors of postoperative clinical course, including ventilation and inotropic support duration, in patients undergoing off-pump coronary artery bypass.
Baseline BNP >100 pg/mL flags higher support needs after off-pump CABG; leaves open utility for preoperative risk stratification.
BACKGROUND: Differential release kinetics of the cardiac biomarkers (B-type natriuretic peptide, troponin I, and creatine kinase-MB) following off-pump coronary artery bypass are not well characterized. METHODS: Biomarker levels were assessed at 6, 24, 48 h, and 1 month preoperatively, in 80 patients who underwent off-pump coronary artery bypass. RESULTS: All biomarkers increased within 6 h of surgery. Peak B-type natriuretic peptide levels occurred at 24-48 h in 96% of patients, but only two-thirds had peak troponin I and creatine kinase-MB levels at this time, reflecting different release patterns. Levels of all biomarkers declined within 48 h, but 42% of patients still had B-type natriuretic peptide >100 pg·mL(-1) at 1 month. Those with baseline B-type natriuretic peptide > 100 pg·mL(-1) had a lower left ventricular ejection fraction (43.6% vs. 55.6%, p < 0.01) and longer inotropic (43.8 vs. 31.4 h, p = 0.03) and ventilator support (34 vs. 25.5 h, p = 0.04) than those with lower levels. B-type natriuretic peptide levels correlated positively with angiographic Syntax score (p = 0.02) and negatively with left ventricular ejection fraction (p < 0.001). Only baseline B-type natriuretic peptide predicted the durations of inotropic support (p = 0.01) and ventilation (p = 0.02). Postoperative B-type natriuretic peptide at 6, 24, and 48 h and delta B-type natriuretic peptide were significant predictors of mean ventilation time. CONCLUSION: Even in patients undergoing off-pump surgery, there is significant natriuretic peptide and myocardial enzyme release. Only B-type natriuretic peptide levels had an association with postoperative variables.
No takes yet. Share an insight, caveat, or question.
Singh et al. (2013) conducted an observational in Off-pump coronary artery bypass (n=80). Baseline B-type natriuretic peptide > 100 pg/mL vs. Lower baseline B-type natriuretic peptide levels was evaluated on Duration of inotropic support (hours) (p=0.03). In patients undergoing off-pump coronary bypass, baseline B-type natriuretic peptide >100 pg/mL was associated with longer inotropic (43.8 vs 31.4 h, p=0.03) and ventilator support.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: