B-type natriuretic peptide predicts postoperative cardiac events and mortality after elective open abdominal aortic aneurysm repair

Bryce, G.J., Payne, D.J., Gibson, S.C., Byrne, D.S., Delles, C. , McClure, J.D. and Kingsmore, D. (2013) B-type natriuretic peptide predicts postoperative cardiac events and mortality after elective open abdominal aortic aneurysm repair. Journal of Vascular Surgery, 57(2), pp. 345-353. (doi: 10.1016/j.jvs.2012.07.053)

Full text not currently available from Enlighten.

Abstract

Objective: The aim of this study was to determine if a single preoperative B-type natriuretic peptide (BNP) level correlated with perioperative cardiac events, cardiac death, and all-cause mortality in elective open abdominal aortic aneurysm (AAA) repair in the short term, intermediate term, and long term.<p></p> Methods: A prospective, 2-year multicenter observational cohort study in the three vascular units in Glasgow was performed. All patients who were admitted for elective open AAA repair were recruited. Preoperative BNP levels were performed and batch analyzed at the end of the study. Postoperative screening for cardiac events (nonfatal myocardial infarction and cardiac death) was performed at 2, 5, and 30 days. Follow-up for all-cause mortality was sustained to a minimum of 3 years, where possible.<p></p> Results: A total of 106 of 111 patients were recruited. Median BNP concentrations were higher in the 16 patients (15%) with immediate postoperative cardiac events (P = .001) and the five with cardiac death (P = .043). Area under the receiver-operating characteristic (AUC) curve analysis indicated BNP concentrations of 99.5 pg/mL best predicted cardiac events (AUC, 0.927), and 448 pg/mL predicted cardiac death (AUC, 0.963). BNP also predicted all-cause mortality in the short-term (P = .028), intermediate-term (P < .001), and long-term (P < .001) postoperative periods.<p></p> Conclusions: Preoperative serum BNP concentration predicted postoperative cardiac events, cardiac death, and all-cause mortality in patients undergoing elective open AAA repair on short-term, intermediate-term, and long-term follow-up on an individual basis with greater accuracy than currently available risk prediction tools.<p></p>

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Byrne, Mr Dominique and Gibson, Mr Simon and Payne, Dr Christopher and Kingsmore, Professor David and Delles, Professor Christian and McClure, Dr John
Authors: Bryce, G.J., Payne, D.J., Gibson, S.C., Byrne, D.S., Delles, C., McClure, J.D., and Kingsmore, D.
College/School:College of Medical Veterinary and Life Sciences
College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Journal of Vascular Surgery
Publisher:Elsevier Inc.
ISSN:0741-5214
ISSN (Online):1097-6809
Published Online:08 October 2012

University Staff: Request a correction | Enlighten Editors: Update this record