DOI QR코드

DOI QR Code

Utility of B-Type Natriuretic Peptide for Predicting Perioperative Cardiovascular Events in Patients Without History of Cardiovascular Disease Undergoing Major Non-Cardiac Surgery

  • Kim, Sung-Eun (Division of Cardiology, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Park, Dae-Gyun (Division of Cardiology, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Lee, Jun-Hee (Division of Cardiology, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Han, Kyoo-Rok (Division of Cardiology, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Oh, Dong-Jin (Division of Cardiology, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine)
  • Published : 2011.01.30

Abstract

Background and Objectives: Patients without previous history of cardiac disease can be regarded as low-risk when undergoing major non-cardiac surgery. The aim of this study was to examine whether preoperative B-type natriuretic peptide (BNP) level predicted postoperative cardiac events in these patients. Subjects and Methods: Preoperative BNP level was measured in 163 patients whose risk was considered low according to the Revised Cardiac Risk Index. Postoperative cardiac events, including death during hospitalization, myocardial injury, arrhythmia, cerebrovascular accidents and congestive heart failure were assessed. Results: Postoperative cardiac events occurred in 8 patients (4.9%). Preoperative BNP levels were significantly higher among patients who experienced postoperative cardiac events, compared to those who did not (130.6${\pm}$148.8 vs. 57.9${\pm}$70.8 pg/mL, p=0.009). Conclusion: Preoperative BNP level may provide prognostic information in low-risk patients undergoing major non-cardiac surgery.

Keywords

References

  1. Goldman L, Caldera DL, Nussbaum SR, et al. Multifactorial index of cardiac risk in noncardiac surgical procedures. N Engl J Med 1977; 297:845-50. https://doi.org/10.1056/NEJM197710202971601
  2. Detsky AS, Abrams HB, Forbath N, Scott JG, Hilliard JR. Cardiac assessment for patients undergoing noncardiac surgery: a multifactorial clinical risk index. Arch Intern Med 1986;146:2131-4. https://doi.org/10.1001/archinte.1986.00360230047007
  3. Goldman L. Multifactorial index of cardiac risk in noncardiac surgery: ten-year status report. J Cardiothorac Anesth 1987;1:237-44. https://doi.org/10.1016/S0888-6296(87)80011-X
  4. Halm EA, Browner WS, Tubau JF, Tateo IM, Mangano DT. Echocardiography for assessing cardiac risk in patients having noncardiac sur-gery: study of perioperative ischemia research group. Ann Intern Med 1996;125:433-41. https://doi.org/10.7326/0003-4819-125-6-199609150-00001
  5. Eagle KA, Berger PB, Calkins H, et al. ACC/AHA guideline update for perioperative cardiovascular evaluation for noncardiac surgery: executive summary a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (committee to update the 1996 guidelines on perioperative cardiovascular evaluation for noncardiac surgery). Circulation 2002;105:1257-67.
  6. de Lemos JA, Morrow DA, Bentley JH, et al. The prognostic value of B-type natriuretic peptide in patients with acute coronary syndromes. N Engl J Med 2001;345:1014-21. https://doi.org/10.1056/NEJMoa011053
  7. Wang TJ, Larson MG, Levy D, et al. Plasma natriuretic peptide levels and the risk of cardiovascular events and death. N Engl J Med 2004;350:655-63. https://doi.org/10.1056/NEJMoa031994
  8. Choe HM, Yoo BS, Ryu HY, et al. The early changing pattern of the B-type natriuretic peptide concentration and its significance as a prognostic marker after acute myocardial infarction. Korean Circ J 2006;36:526-34.
  9. Chung IH, Yoo BS, Ryu HY, et al. The relationship between the early follow-up BNP level and congestive status or prognosis in acute heart failure. Korean Circ J 2006;36:200-7.
  10. Dernellis J, Panaretou M. Assessment of cardiac risk before non-cardiac surgery: brain natriuretic peptide in 1590 patients. Heart 2006;92:1645-50. https://doi.org/10.1136/hrt.2005.085530
  11. Feringa HH, Bax JJ, Elhendy A, et al. Association of plasma N-terminal pro-B-type natriuretic peptide with postoperative cardiac events in patients undergoing surgery for abdominal aortic aneurysm or leg by-pass. Am J Cardiol 2006;98:111-5. https://doi.org/10.1016/j.amjcard.2006.01.058
  12. Cuthbertson BH, Amiri AR, Croal BL, et al. Utility of B-type natriure-tic peptide in predicting perioperative cardiac events in patients under-going major non-cardiac surgery. Br J Anaesth 2007;99:170-6. https://doi.org/10.1093/bja/aem158
  13. Cuthbertson BH, Card G, Croal BL, McNeilly J, Hillis GS. The utility of B-type natriuretic peptide in predicting postoperative cardiac events and mortality in patients undergoing major emergency non-cardiac sur-gery. Anaesthesia 2007;62:875-81. https://doi.org/10.1111/j.1365-2044.2007.05146.x
  14. Gibson SC, Payne CJ, Byrne DS, Berry C, Dargie HJ, Kingsmore DB. B-type natriuretic peptide predicts cardiac morbidity and mortality af-ter major surgery. Br J Surg 2007;94:903-9. https://doi.org/10.1002/bjs.5690
  15. Lee TH, Marcantonio ER, Mangione CM, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation 1999;100:1043-9. https://doi.org/10.1161/01.CIR.100.10.1043
  16. Gilbert K, Larocque BJ, Patrick LT. Prospective evaluation of cardiac risk indices for patients undergoing noncardiac surgery. Ann Intern Med 2000;133:356-9. https://doi.org/10.7326/0003-4819-133-5-200009050-00011
  17. Daniels LB, Maisel AS. Natriuretic peptides. J Am Coll Cardiol 2007;50:2357-68. https://doi.org/10.1016/j.jacc.2007.09.021
  18. Vaziri SM, Larson MG, Benjamin EJ, Levy D. Echocardiographic pre-dictors of nonrheumatic atrial fibrillation: the Framingham Heart St-udy. Circulation 1994;89:724-30. https://doi.org/10.1161/01.CIR.89.2.724
  19. Benjamin EJ, D'Agostino RB, Belanger AJ, Wolf PA, Levy D. Left atrial size and the risk of stroke and death: the Framingham Heart Study. Circulation 1995;92:835-41. https://doi.org/10.1161/01.CIR.92.4.835
  20. Laukkanen JA, Kurl S, Eranen J, Huttunen M, Salonen JT. Left atrium size and the risk of cardiovascular death in middle-aged men. Arch Intern Med 2005;165:1788-93. https://doi.org/10.1001/archinte.165.15.1788
  21. Bayes-Genis A, Vazquez R, Puig T, et al. Left atrial enlargement and NT-proBNP as predictors of sudden cardiac death in patients with he-art failure. Eur J Heart Fail 2007;9:802-7. https://doi.org/10.1016/j.ejheart.2007.05.001
  22. Miller JT, O'Rourke RA, Crawford MH. Left atrial enlargement: an early sign of hypertensive heart disease. Am Heart J 1988;116:1048-51. https://doi.org/10.1016/0002-8703(88)90158-5
  23. Tsioufis C, Stougiannos P, Taxiarchou E, et al. The interplay between haemodynamic load, brain natriuretic peptide and left atrial size in the early stages of essential hypertension. J Hypertens 2006;24:965-72. https://doi.org/10.1097/01.hjh.0000222768.15100.00

Cited by

  1. Significance of the perioperative measurement of brain natriuretic peptide (BNP) in general thoracic surgery vol.27, pp.1, 2011, https://doi.org/10.2995/jacsurg.27.3
  2. Usefulness of Surgical Parameters as Predictors of Postoperative Cardiac Events in Patients Undergoing Non-Cardiac Surgery vol.78, pp.3, 2014, https://doi.org/10.1253/circj.cj-13-1208
  3. Preoperative B-type natriuretic peptides in patients undergoing noncardiac surgery: a cumulative meta-analysis vol.21, pp.4, 2011, https://doi.org/10.1080/22201181.2015.1075938
  4. Potential New Approaches in Predicting Adverse Cardiac Events One Month after Major Vascular Surgery vol.28, pp.1, 2011, https://doi.org/10.1159/000495079