Per Vikholm1, Petter Schiller2, Laila Hellgren2. 1. Department of Cardiothoracic Surgery, Uppsala University Hospital, Uppsala, Sweden. Electronic address: per.vikholm@akademiska.se. 2. Department of Cardiothoracic Surgery, Uppsala University Hospital, Uppsala, Sweden.
Abstract
OBJECTIVES: N-terminal brain natriuretic peptide (NT-proBNP) is an established biomarker of heart failure and has been found to predict mortality and morbidity after cardiac surgery. The aim of this study was to investigate whether preoperative NT-proBNP can predict postoperative New York Heart Association (NYHA) functional class and hospital readmission in addition to morbidity and mortality. DESIGN: Retrospective. SETTING: University hospital. PARTICIPANTS: All patients undergoing aortic valve replacement for aortic stenosis and coronary artery bypass grafting from January to December 2008 (n = 390). MEASUREMENTS AND MAIN RESULTS: Preoperative NT-proBNP was recorded prospectively. Five-year mortality was obtained through national registries. Postoperative functional class, morbidity, and hospital readmission were obtained through telephone interviews. Patients were divided into quartiles based on preoperative NT-proBNP; the medians of each quartile were 103 ng/L, 291 ng/L, 825 ng/L and 2,375 ng/L. Increased preoperative NT-proBNP was associated with reduced postoperative functional class. In the first quartile, 7% (7/97) were in NYHA functional class III-IV compared to 26% (25/97) in the fourth quartile (p<0.01). Increased preoperative NT-proBNP was also associated with reduced long-term survival (p<0.01). The covariate adjusted hazard ratio for mortality in the fourth quartile was 2.9 (1.61-5.08; p<0.01) compared to the other quartiles. No association was found between preoperative NT-proBNP and postoperative hospital readmission. CONCLUSIONS: Increased preoperative NT-proBNP is associated with reduced long-term survival and functional class but not hospital readmission post-cardiac surgery. Thus, NT-proBNP might have additive value to established risk factors in the preoperative assessment of patients undergoing cardiac surgery.
OBJECTIVES: N-terminal brain natriuretic peptide (NT-proBNP) is an established biomarker of heart failure and has been found to predict mortality and morbidity after cardiac surgery. The aim of this study was to investigate whether preoperative NT-proBNP can predict postoperative New York Heart Association (NYHA) functional class and hospital readmission in addition to morbidity and mortality. DESIGN: Retrospective. SETTING: University hospital. PARTICIPANTS: All patients undergoing aortic valve replacement for aortic stenosis and coronary artery bypass grafting from January to December 2008 (n = 390). MEASUREMENTS AND MAIN RESULTS: Preoperative NT-proBNP was recorded prospectively. Five-year mortality was obtained through national registries. Postoperative functional class, morbidity, and hospital readmission were obtained through telephone interviews. Patients were divided into quartiles based on preoperative NT-proBNP; the medians of each quartile were 103 ng/L, 291 ng/L, 825 ng/L and 2,375 ng/L. Increased preoperative NT-proBNP was associated with reduced postoperative functional class. In the first quartile, 7% (7/97) were in NYHA functional class III-IV compared to 26% (25/97) in the fourth quartile (p<0.01). Increased preoperative NT-proBNP was also associated with reduced long-term survival (p<0.01). The covariate adjusted hazard ratio for mortality in the fourth quartile was 2.9 (1.61-5.08; p<0.01) compared to the other quartiles. No association was found between preoperative NT-proBNP and postoperative hospital readmission. CONCLUSIONS: Increased preoperative NT-proBNP is associated with reduced long-term survival and functional class but not hospital readmission post-cardiac surgery. Thus, NT-proBNP might have additive value to established risk factors in the preoperative assessment of patients undergoing cardiac surgery.
Authors: Jeffrey P Jacobs; Shama S Alam; Sherry L Owens; Devin M Parker; Michael Rezaee; Donald S Likosky; David M Shahian; Marshall L Jacobs; Heather Thiessen-Philbrook; Moritz Wyler von Ballmoos; Kevin Lobdell; Todd MacKenzie; Allen D Everett; Chirag R Parikh; Jeremiah R Brown Journal: Ann Thorac Surg Date: 2018-06-01 Impact factor: 4.330
Authors: Jeremiah R Brown; Devin M Parker; Meagan E Stabler; Marshall L Jacobs; Jeffrey P Jacobs; Allen D Everett; Kevin W Lobdell; Moritz C Wyler von Ballmoos; Heather Thiessen-Philbrook; Chirag Parikh; Todd Mackenzie; Anthony DiScipio; David Malenka; Michael E Matheny; Alexander Turchin; Donald S Likosky Journal: J Card Surg Date: 2021-09-02 Impact factor: 1.778