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Predictors of mortality in cardiac surgery: brain natriuretic peptide type B
Jamil Alli Murad Junior1, Marcelo Arruda Nakazone1, Mauricio de Nassau Machado1
1Hospital de Base, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil.
Insights
Preoperative brain natriuretic peptide (BNP) levels predict mortality in cardiac surgery patients. Elevated BNP greater than 382 pg/mL independently indicates a higher risk of 30-day mortality after valve or coronary artery bypass grafting surgery.
Area of Science:
- Cardiology
- Biomarkers
- Surgical Outcomes
Background:
- Cardiac surgery, including valve replacement and coronary artery bypass grafting (CABG), carries inherent risks.
- Predicting postoperative mortality is crucial for patient management and risk stratification.
Purpose of the Study:
- To determine if preoperative serum brain natriuretic peptide (BNP) concentration predicts in-hospital mortality in patients undergoing cardiac surgery.
Main Methods:
- A prospective study evaluated 488 patients undergoing cardiac valve surgery or CABG between 2009 and 2012.
- Patients were followed for 30 days postoperatively.
- Receiver Operating Characteristic (ROC) curve and multivariate analyses were performed.
Main Results:
- The overall mortality rate was 9.6%.
- An optimal BNP cutoff of 382 pg/mL for predicting mortality was identified (AUC=0.73).
- Preoperative BNP > 382 pg/mL was an independent predictor of 30-day mortality (P=0.033, HR=2.05).
Conclusions:
- Preoperative serum BNP concentration is a significant independent predictor of mortality in patients undergoing valve surgery or CABG.
- BNP serves as a valuable biomarker for risk assessment in cardiac surgical patients.
Objective:
We evaluated whether the preoperative serum concentration of brain natriuretic peptide (BNP) is a predictor of in-hospital mortality in patients that underwent cardiac surgery.
Methods:
We continuously evaluated 488 patients that underwent cardiac valve surgery or coronary artery bypass grafting (CABG) between January of 2009 and July of 2012. Follow up of these patients were done prospectively for 30 days postoperatively.
Results:
Data analysis showed that the overall mortality rate was equal to 9.6%, Receiver Operating Charactheristic (ROC) curve analysis found the optimal cut-off value of BNP equal to 382 pg/mL for overall mortality (AUC=0.73, 95% CI=0.66 to 0.81, P<0.001). Multivariate analysis showed that the value of BNP higher than 382 pg/mL (P=0.033, HR=2.05, 95% CI=1.6 to 3.98) was an independent predictor of overall mortality at 30 days postoperatively.
Conclusion:
We concluded that the preoperative serum concentration of BNP is an independent predictor of mortality in patients undergoing valve surgery or coronary artery bypass graft.
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