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Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Mahla, E; Baumann, A; Rehak, P; Watzinger, N; Vicenzi, MN; Maier, R; Tiesenhausen, K; Metzler, H; Toller, W.
N-terminal pro-brain natriuretic peptide identifies patients at high risk for adverse cardiac outcome after vascular surgery.
Anesthesiology. 2007; 106(6): 1088-1095.
Doi: 10.1097/01.anes.0000267591.34626.b0
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- Leading authors Med Uni Graz
- Mahla Elisabeth
- Co-authors Med Uni Graz
- Baumann Anneliese
- Maier Robert
- Metzler Helfried
- Rehak Peter
- Tiesenhausen Kurt
- Toller Wolfgang
- Vicenzi Martin
- Watzinger Norbert
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- Abstract:
- BACKGROUND: Preoperative N-terminal pro-BNP (NT-proBNP) is independently associated with adverse cardiac outcome but does not anticipate the dynamic consequences of anesthesia and surgery. The authors hypothesized that a single postoperative NT-proBNP level provides additional prognostic information for in-hospital and late cardiac events. METHODS: Two hundred eighteen patients scheduled to undergo vascular surgery were enrolled and followed up for 24-30 months. Logistic regression and Cox proportional hazards model were performed to evaluate predictors of in-hospital and long-term cardiac outcome. The optimal discriminatory level of preoperative and postoperative NT-proBNP was determined by receiver operating characteristic analysis. RESULTS: During a median follow-up of 826 days, 44 patients (20%) experienced 51 cardiac events. Perioperatively, median NT-proBNP increased from 215 to 557 pg/ml (interquartile range, 83/457 to 221/1178 pg/ml; P<0.001). The optimum discriminate threshold for preoperative and postoperative NT-proBNP was 280 pg/ml (95% confidence interval, 123-400) and 860 pg/ml (95% confidence interval, 556-1,054), respectively. Adjusted for age, previous myocardial infarction, preoperative fibrinogen, creatinine, high-sensitivity C-reactive protein, type, duration, and surgical complications, only postoperative NT-proBNP remained significantly associated with in-hospital (adjusted hazard ratio, 19.8; 95% confidence interval, 3.4-115) and long-term cardiac outcome (adjusted hazard ratio, 4.88; 95% confidence interval, 2.43-9.81). CONCLUSION: A single postoperative NT-proBNP determination provides important additional prognostic information to preoperative levels and may support therapeutic decisions to prevent subsequent structural myocardial damage.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Comorbidity -
- Disease-Free Survival -
- Female -
- Follow-Up Studies -
- Humans -
- Logistic Models -
- Male -
- Myocardial Infarction - blood
- Natriuretic Peptide, Brain - blood
- Peptide Fragments - blood
- Postoperative Complications - blood Postoperative Complications - diagnosis
- Preoperative Care -
- Prognosis -
- Vascular Surgical Procedures -