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Natriuretic Peptides as a Predictor for Delirium After Cardiac Surgery: A Prospective Observational Study
Cyril Huisinga1, Eric Struck1, Lorenz Mihatsch2
1Department of Anaesthesiology, LMU University Hospital, Ludwig-Maximilians-Universität, 81377 Munich, Germany.
Journal of Clinical Medicine
|March 17, 2025
Summary
Elevated natriuretic peptide levels before cardiac surgery are linked to postoperative delirium. Preoperative NT-proCNP may serve as a new risk factor for delirium, impacting patient recovery.
Area of Science:
- Cardiology
- Neurology
- Critical Care Medicine
Background:
- Post-cardiac surgery delirium affects over a third of patients.
- Natriuretic peptides, released during surgery, disrupt the blood-brain barrier and potentiate dopamine agonists, contributing to delirium.
- Understanding preoperative predictors is crucial for preventing postoperative delirium.
Purpose of the Study:
- To investigate the association between preoperative natriuretic peptide concentration and the occurrence of delirium after cardiac surgery.
- To explore differences in cognitive performance, quality of life, and physical performance between patients with and without delirium.
Main Methods:
- A single-center observational study involving 80 patients undergoing elective cardiac surgery.
- Preoperative NT-pro C-type natriuretic peptide (NT-proCNP) levels were measured.
- Delirium was assessed postoperatively using the confusion assessment method for intensive care; quality of life and physical performance data were also collected.
Main Results:
- 35% of patients developed delirium.
- Patients with delirium exhibited significantly higher preoperative NT-proCNP levels (p=0.016).
- Delirious patients reported pre-existing declines in physical role function, vitality, and social function.
Conclusions:
- Elevated preoperative NT-proCNP is associated with an increased risk of postoperative delirium.
- Preoperative reductions in cognitive and physical function may represent novel risk factors for delirium.
- NT-proCNP warrants further investigation as a potential biomarker for delirium risk stratification.
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