Is brain natriuretic peptide a marker for adverse postoperative outcomes in patients undergoing cardiac surgery?

A best evidence topic (BET) was constructed according to a structured protocol. The question addressed was 'Is brain natriuretic peptide (BNP) a marker for adverse postoperative outcomes in patients undergoing cardiac surgery?' Nearly 200 papers were found using the reported search, of which 17 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. BNP levels have been shown by several prospective observational cohort studies to be a marker for cardiac dysfunction and adverse outcome in patients undergoing cardiac surgery. BNP levels can be used to guide the therapy of patients with heart failure which may reduce adverse cardiac events. Whether BNP-guided therapy can be applied to patients undergoing cardiac surgery is unknown. We conclude that preoperative and postoperative measurement of natriuretic peptides could help predict postoperative cardiac dysfunction and adverse outcome in patients undergoing cardiac surgery. Furthermore, they may improve the ability of commonly used risk assessment tools to predict outcome.