Related Experiment Video
Updated: Jul 2, 2026
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Preoperative B-type natriuretic peptide is as independent predictor of ventricular dysfunction and mortality after
Amanda A Fox1, Stanton K Shernan, Charles D Collard
1Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. afox@partners.org
Insights
Preoperative B-type natriuretic peptide levels predict adverse outcomes in cardiac surgery patients. Elevated levels independently indicated worse ventricular function, longer hospital stays, and increased mortality after coronary artery bypass grafting.
Area of Science:
- Cardiology
- Cardiac Surgery
- Biomarkers
Background:
- Elevated B-type natriuretic peptide (BNP) is linked to poor outcomes in heart failure and acute coronary syndromes.
- The predictive value of BNP for cardiac surgery outcomes remains unclear.
Purpose of the Study:
- To determine if preoperative plasma BNP independently predicts postoperative ventricular dysfunction, hospital stay, and 5-year mortality after primary coronary artery bypass grafting (CABG).
Main Methods:
- Prospective, longitudinal study of 1023 patients undergoing primary CABG with cardiopulmonary bypass.
- Ventricular dysfunction defined by need for inotropes, intra-aortic balloon pump, or ventricular assist device.
- Multivariable analyses assessed BNP's predictive role for outcomes.
Main Results:
- Preoperative BNP predicted ventricular dysfunction (OR 1.92, P=.018), longer hospital stay (HR 1.42, P=.0002), and 5-year mortality (HR 1.89, P=.026).
- These predictions remained independent after adjusting for clinical factors like ejection fraction and heart failure severity.
Conclusions:
- Preoperative plasma BNP is an independent predictor of in-hospital ventricular dysfunction.
- Preoperative plasma BNP also independently predicts prolonged hospital stay and up to 5-year all-cause mortality following primary CABG.
Objective:
Elevated B-type natriuretic peptide is associated with increased morbidity and mortality in ambulatory patients with congestive heart failure or acute coronary syndromes. Its utility in predicting adverse cardiac surgical outcomes is less certain. We hypothesized that preoperative plasma B-type natriuretic peptide would independently predict in-hospital postoperative ventricular dysfunction, hospital stay, and up to 5-year mortality after primary coronary artery bypass grafting.
Methods:
This is a prospective, longitudinal study of 1023 patients at two institutions undergoing primary coronary artery bypass grafting with cardiopulmonary bypass. Ventricular dysfunction was defined as requirement for at least two inotropes or new intra-aortic balloon pump or ventricular assist device support after coronary artery bypass grafting. Multivariable analyses assessed independent roles of preoperative B-type natriuretic peptide in predicting postoperative ventricular dysfunction, hospital stay, and 5-year all-cause mortality.
Results:
Preoperative plasma B-type natriuretic peptide concentration predicted ventricular dysfunction, hospital stay, and mortality in univariate and multivariable analyses. Logistic regression demonstrated preoperative B-type natriuretic peptide to independently predict ventricular dysfunction (odds ratio 1.92, 95% confidence interval 1.12-3.29, P = .018), after adjustment for preoperative left ventricular ejection fraction, congestive heart failure severity, and other clinical predictors. Multivariable Cox proportional hazards models showed preoperative B-type natriuretic peptide to independently predict hospital stay (hazard ratio 1.42, 95% confidence interval 1.18-1.72, P = .0002) and mortality (hazard ratio 1.89, 95% confidence interval 1.08-3.33, P = .026).
Conclusion:
Preoperative plasma B-type natriuretic peptide independently predicted in-hospital ventricular dysfunction, hospital stay, and up to 5-year all-cause mortality after primary coronary artery bypass grafting.
Related Concept Videos
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:29Heart Failure II: Pathophysiology