PMID- 24731743
OWN - NLM
STAT- MEDLINE
DCOM- 20150120
LR  - 20140611
IS  - 1532-8422 (Electronic)
IS  - 1053-0770 (Linking)
VI  - 28
IP  - 3
DP  - 2014 Jun
TI  - Preoperative brain natriuretic peptide predicts late mortality and functional 
      class but not hospital readmission after cardiac surgery.
PG  - 520-7
LID - S1053-0770(14)00007-X [pii]
LID - 10.1053/j.jvca.2014.01.002 [doi]
AB  - 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.
CI  - Copyright (c) 2014 Elsevier Inc. All rights reserved.
FAU - Vikholm, Per
AU  - Vikholm P
AD  - Department of Cardiothoracic Surgery, Uppsala University Hospital, Uppsala, 
      Sweden. Electronic address: per.vikholm@akademiska.se.
FAU - Schiller, Petter
AU  - Schiller P
AD  - Department of Cardiothoracic Surgery, Uppsala University Hospital, Uppsala, 
      Sweden.
FAU - Hellgren, Laila
AU  - Hellgren L
AD  - Department of Cardiothoracic Surgery, Uppsala University Hospital, Uppsala, 
      Sweden.
LA  - eng
PT  - Journal Article
DEP - 20140414
PL  - United States
TA  - J Cardiothorac Vasc Anesth
JT  - Journal of cardiothoracic and vascular anesthesia
JID - 9110208
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Aged
MH  - Atrial Fibrillation/epidemiology/etiology/mortality
MH  - Cardiac Surgical Procedures/*adverse effects
MH  - Cardiopulmonary Bypass
MH  - Female
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/*blood
MH  - Patient Readmission/*statistics & numerical data
MH  - Postoperative Complications/*blood/*mortality
MH  - Predictive Value of Tests
MH  - Preoperative Period
MH  - Retrospective Studies
MH  - Survival Analysis
OTO - NOTNLM
OT  - B-type natriuretic peptide
OT  - cardiac surgery
OT  - heart failure
OT  - morbidity
OT  - mortality
OT  - postoperative outcome
EDAT- 2014/04/16 06:00
MHDA- 2015/01/21 06:00
CRDT- 2014/04/16 06:00
PHST- 2013/10/23 00:00 [received]
PHST- 2014/04/16 06:00 [entrez]
PHST- 2014/04/16 06:00 [pubmed]
PHST- 2015/01/21 06:00 [medline]
AID - S1053-0770(14)00007-X [pii]
AID - 10.1053/j.jvca.2014.01.002 [doi]
PST - ppublish
SO  - J Cardiothorac Vasc Anesth. 2014 Jun;28(3):520-7. doi: 
      10.1053/j.jvca.2014.01.002. Epub 2014 Apr 14.