PMID- 32808054
OWN - NLM
STAT- MEDLINE
DCOM- 20210121
LR  - 20210121
IS  - 1432-1971 (Electronic)
IS  - 0172-0643 (Linking)
VI  - 41
IP  - 8
DP  - 2020 Dec
TI  - Risk Factors for Cardiac Adverse Events in Infants and Children with Complex 
      Heart Disease Scheduled for Bi-ventricular Repair: Prognostic Value of 
      Pre-operative B-Type Natriuretic Peptide and High-Sensitivity Troponin T.
PG  - 1756-1765
LID - 10.1007/s00246-020-02437-5 [doi]
AB  - Few reports have described the prognostic value of measuring both B-type 
      natriuretic peptides (BNP) and high-sensitivity troponin T (hs-TnT) in pediatric 
      patients with complex congenital heart disease (CHD) undergoing surgery. We 
      assessed demographic, hemodynamic, and laboratory data, including BNP and hs-TnT 
      levels, for the prediction of cardiac adverse events in 85 patients. Cardiac 
      adverse events were defined as death, cardiac arrest, worsening heart failure 
      requiring inotropic agents and/or respiratory support, and unscheduled 
      surgery/intervention either within or after 12 months of surgery. There were 17 
      cardiac adverse events. Of the demographic variables, low birth weight (< 2500 g: 
      Odds ratio [OR], 5.97; 95% confidential interval [CI] 1.48-24.0; p = 0.001) and 
      Ross/New York Heart Association [NYHA] class (>/= 2.0) (OR 12.7; 95% CI 3.08-52.7; 
      p = 0.0004) were strongly association with cardiac adverse events. Among 
      hemodynamic and laboratory variables, preoperative BNP (OR 14.04; 95% CI 
      2.15-91.7; p = 0.001) and hs-TnT levels (OR 16.66; 95% CI 2.27-122; p = 0.002) 
      were found to be independent risk factors. Receiver operating characteristic 
      analysis determined BNP and hs-TnT levels of 60.9 pg/mL and 0.025 ng/mL, 
      respectively, to be markers of high risk. Kaplan-Meier analysis demonstrated 
      significant differences in the freedom from cardiac adverse events between Group 
      A (BNP or hs-TnT elevated, n = 26) and Group B (both biomarkers elevated, n = 19; 
      log-rank, p < 0.001). In conclusion, low birth weight (< 2500 g) and Ross/NYHA 
      class >/= 2.0 are strongly associated with cardiac adverse events. Preoperative BNP 
      and hs-TnT also provide prognostic information in patients with complex CHD 
      scheduled for surgery. Using both markers in combination predicts cardiac adverse 
      events better than using either separately.
FAU - Mori, Yoshiki
AU  - Mori Y
AUID- ORCID: 0000-0002-0930-8971
AD  - Division of Pediatric Cardiology, Seirei Hamamatsu General Hospital, Hamamatsu, 
      Shizuoka, Japan. yoshikim@globe.ocn.ne.jp.
FAU - Nakashima, Yasumi
AU  - Nakashima Y
AD  - Division of Pediatric Cardiology, Seirei Hamamatsu General Hospital, Hamamatsu, 
      Shizuoka, Japan.
FAU - Kaneko, Sachie
AU  - Kaneko S
AD  - Division of Pediatric Cardiology, Seirei Hamamatsu General Hospital, Hamamatsu, 
      Shizuoka, Japan.
FAU - Inoue, Nao
AU  - Inoue N
AD  - Division of Pediatric Cardiology, Seirei Hamamatsu General Hospital, Hamamatsu, 
      Shizuoka, Japan.
FAU - Murakami, Tomotaka
AU  - Murakami T
AD  - Division of Pediatric Cardiology, Seirei Hamamatsu General Hospital, Hamamatsu, 
      Shizuoka, Japan.
LA  - eng
PT  - Journal Article
DEP - 20200817
PL  - United States
TA  - Pediatr Cardiol
JT  - Pediatric cardiology
JID - 8003849
RN  - 0 (Biomarkers)
RN  - 0 (Troponin T)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Biomarkers/blood
MH  - Cardiac Surgical Procedures/*adverse effects
MH  - Female
MH  - Heart Arrest/epidemiology
MH  - Heart Defects, Congenital/*blood/*surgery
MH  - Heart Failure/epidemiology
MH  - Humans
MH  - Infant
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Natriuretic Peptide, Brain/*blood
MH  - Preoperative Period
MH  - Prognosis
MH  - Prospective Studies
MH  - ROC Curve
MH  - Risk Factors
MH  - Troponin T/*blood
OTO - NOTNLM
OT  - Complex congenital heart disease
OT  - Natriuretic peptides
OT  - Pediatric cardiac surgery
OT  - Risk stratification
OT  - Troponin
EDAT- 2020/08/19 06:00
MHDA- 2021/01/22 06:00
CRDT- 2020/08/19 06:00
PHST- 2020/05/08 00:00 [received]
PHST- 2020/08/07 00:00 [accepted]
PHST- 2020/08/19 06:00 [pubmed]
PHST- 2021/01/22 06:00 [medline]
PHST- 2020/08/19 06:00 [entrez]
AID - 10.1007/s00246-020-02437-5 [pii]
AID - 10.1007/s00246-020-02437-5 [doi]
PST - ppublish
SO  - Pediatr Cardiol. 2020 Dec;41(8):1756-1765. doi: 10.1007/s00246-020-02437-5. Epub 
      2020 Aug 17.