Key result
High preoperative NT-pro BNP levels correlated with increased ventilation time (r=0.46) and ICU stay (r=0.59), but did not predict postoperative atrial fibrillation or mortality.
Why the study?
Do preoperative and postoperative NT-pro BNP levels correlate with clinical recovery endpoints in adult patients undergoing cardiac surgery?
Observational (n=118)
No
Do preoperative and postoperative NT-pro BNP levels correlate with clinical recovery endpoints in adult patients undergoing cardiac surgery?
High preoperative NT-pro BNP levels in cardiac surgery patients are associated with slower postoperative recovery, including longer ventilation and ICU stay, but do not predict mortality or atrial fibrillation.
Does not support routine NT-proBNP use to predict AF or mortality after cardiac surgery; hypothesis-generating for recovery duration.
The primary objective of this study was to determine the pattern of N-Terminal pro brain natriuretic peptide (NT-pro BNP) secretion pre and post cardiac surgery and then to investigate the correlation between levels of serum NT-pro BNP and postoperative clinical and biochemical endpoints. This was a prospective observational study performed at a tertiary centre in New Zealand, examining 118 adult patients undergoing cardiac surgery. Interventions included blood samples for NT-pro BNP and troponin-T taken 48 hours prior to operation and 12, 36 and 72 hours postoperatively. The plasma NT-pro BNP levels increased fourfold postoperatively, to plateau at 36 to 72 hours. Preoperative NT-pro BNP levels correlated with ventilation time (r = 0.46), length of stay in intensive care unit (r = 0.59), total perioperative noradrenaline dose (r = 0.55), but not with postoperative atrial fibrillation or mortality. Using multivariate analysis, serum NT-pro BNP levels at 36 hours were associated with increased noradrenaline dose (P = 0.001), decreased preoperative ejection fraction (EF) Group (P = 0.013) and elevated preoperative NT-pro BNP (P < 0.001). Factors not associated with NT-pro BNP levels at 36 hours include the operation type, bypass and cross-clamp times, use of milrinone and troponin-T We conclude that NT-pro BNP levels increased markedly after cardiac surgery and that high preoperative NT-pro BNP levels are associated with a slow postoperative recovery, but do not predict the occurrence of postoperative atrial fibrillation or mortality. Myocardial ischaemia is an unlikely cause of the NT-pro BNP elevation, because no correlation existed between troponin-T and NT-pro BNP levels.
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Jogia et al. (2007) conducted an observational in Cardiac surgery (n=118). Preoperative NT-pro BNP levels was evaluated on Postoperative clinical and biochemical endpoints including ventilation time, ICU length of stay, and noradrenaline dose. High preoperative NT-pro BNP levels correlated with increased ventilation time (r=0.46) and ICU stay (r=0.59), but did not predict postoperative atrial fibrillation or mortality.
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