Prognostic power of pre- and postoperative B-type natriuretic peptide levels in patients undergoing abdominal aortic surgery.

Abstract

OBJECTIVES:

The first aim of the present study was to evaluate the pre- and postoperative B-type natriuretic peptide (BNP) levels in patients undergoing surgery for repair of an infrarenal abdominal aortic aneurysm (AAA) and analyze their power as a predictor of in-hospital cardiac events. The second aim was to evaluate the association among pre- and postoperative BNP levels, postoperative patient complications, and length of hospital stay.

DESIGN:

Prospective observational study.

SETTING:

A university hospital.

PARTICIPANTS:

Forty-five patients undergoing elective surgery for an abdominal aortic aneurysm.

INTERVENTIONS:

The plasma BNP level was assessed just before surgery and then on postoperative day 1. Cardiac troponin I levels were measured postoperatively on arrival to the intensive care unit (time 0) and then 12, 48, and 72 hours later.

MEASUREMENTS AND MAIN RESULTS:

The preoperative BNP concentration in patients who developed an acute myocardial infarction was 209 (IQR 84-346) pg/mL compared with 74 (IQR 28-142) pg/mL in those who did not. The difference between groups was statistically significant (p = 0.04). The Spearman correlation showed that postoperative BNP levels correlated significantly with preoperative BNP levels (r = 0.73, p = 0.0001), length of hospital stay (r = 0.35, p = 0.04), and troponin I concentration at 0 hour (r = 0.42, p = 0.02), 12 hours (r = 0.51, p = 0.0052), and 48 hours (r = 0.40, p = 0.033). In contrast, preoperative BNP levels correlated with troponin I at only 12 hours (r = 0.34, p = 0.02). Postoperative BNP levels were influenced significantly by transfusions (p = 0.035) and cross-clamping times (p = 0.038).

CONCLUSIONS:

The present results confirm the high negative predictive value of preoperative BNP levels; and postoperative BNP levels showed a better correlation with postoperative troponin levels, blood transfusion, and postoperative cardiac events.

• Authors: Luigi Vetrugno, Maria Gabriella Costa, Livia Pompei, Paolo Chiarandini, Daniela Drigo, Flavio Bassi, Nevio Gonano, Rodolfo Muzzi, Giorgio Della Rocca
• Journal: Journal of cardiothoracic and vascular anesthesia (J Cardiothorac Vasc Anesth) Vol. 26 Issue 4 Pg. 637-42 (Aug 2012) ISSN: 1532-8422 [Electronic] United States
• PMID: 22387082 (Publication Type: Journal Article)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Chemical References

• Peptide Fragments
• Troponin I
• pro-brain natriuretic peptide (1-76)
• Natriuretic Peptide, Brain

Topics

• Aged
• Aorta, Abdominal (surgery)
• Aortic Aneurysm, Abdominal (blood, surgery)
• Female
• Humans
• Length of Stay
• Male
• Middle Aged
• Natriuretic Peptide, Brain (blood)
• Peptide Fragments (blood)
• Postoperative Period
• Predictive Value of Tests
• Preoperative Period
• Prognosis
• Prospective Studies
• Troponin I (blood)