Key result
Pro-ANP levels >180.5 pg/ml after cardiopulmonary bypass were significantly associated with an increased risk of postoperative complications (OR 9.722; 95% CI 2.554-37.004; p=0.0007).
Why the study?
Do intraoperative pro-ANP dynamics predict postoperative complications in patients undergoing cardiac surgery?
Observational (n=81)
Do intraoperative pro-ANP dynamics predict postoperative complications in patients undergoing cardiac surgery?
Odds Ratio: 9.722 (95% CI 2.554–37.004)
p-value: p=0.0007
Elevated pro-ANP levels after cardiopulmonary bypass are strongly associated with an increased risk of postoperative complications in cardiac surgery patients.
Pro-ANP rise after bypass may flag higher complication risk for closer monitoring; leaves open incremental prognostic value beyond standard scores.
Background. Nowadays, atrial natriuretic peptide is more often used to determine severity and predict treatment outcomes in patients with cardiac failure and/or atrial fibrillation. Atrial natriuretic peptide was described as prognostic marker of postoperative complications in cardiac surgery patients. However, available data are insufficient and inspired this study. Objective. To determine the correlation between intraoperative pro-ANP dynamics and postoperative complications in cardiac surgery patients. Material and methods. There were 81 cardiac surgery patients. Inclusion criteria were thoracic aorta repair, coronary artery bypass surgery, valve procedures, etc. Blood samples were taken at 4 stages: before induction of anesthesia, before and after cardiopulmonary bypass, at the end of surgery. Results. There was a relationship between pro-ANP level and the number of patients (25 out of 81) with ≥1 postoperative complications. Complicated postoperative period is characterized by higher pro-ANP after cardiopulmonary bypass (224.05 [198; 282] pg/ml and 173.45 [112; 266] pg/ml, respectively, p=0.0391). Risk factors of postoperative complications were pro-ANP after cardiopulmonary bypass >180.5 pg/ml (OR 9.722, CI 2.554—37.004, p=0.0007) and pro-ANP increment by more than 1.46 times throughout cardiopulmonary bypass (OR 4.259, CI 1.380—13.147, p=0.010). Patients with postoperative vascular insufficiency are characterized by higher pro-ANP at the end of cardiopulmonary bypass (254.90 (215.20—326.00) pg/ml and 196.00 (115.60—263.90) pg/ml, respectively, p=0.028). Risk factor of postoperative vascular insufficiency is pro-ANP before cardiopulmonary bypass >124.15 pg/ml (OR 6.058, CI 1.141—32.175, p=0.032). Conclusion. Increased pro-ANP after cardiopulmonary bypass is associated with higher incidence of postoperative complications. Pro-ANP before cardiopulmonary bypass >124.15 pg/ml is a risk factor of postoperative vascular insufficiency. Pro-ANP increment after cardiopulmonary bypass compared to baseline value is associated with length of hospital-stay.
No takes yet. Share an insight, caveat, or question.
Akselrod et al. (2023) conducted an observational in cardiac surgery (n=81). Pro-ANP after cardiopulmonary bypass >180.5 pg/ml vs. Pro-ANP ≤180.5 pg/ml was evaluated on ≥1 postoperative complications (OR 9.722, 95% CI 2.554-37.004, p=0.0007). Pro-ANP levels >180.5 pg/ml after cardiopulmonary bypass were significantly associated with an increased risk of postoperative complications (OR 9.722; 95% CI 2.554-37.004; p=0.0007).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: