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Published in: World Journal of Surgery 1/2012

01-01-2012

Preoperative Brain Natriuretic Peptide (BNP) Is a Better Predictor of Adverse Cardiac Events Compared to Preoperative Scoring System in Patients Who Underwent Abdominal Surgery

Authors: Paolo Mercantini, Salvatore Di Somma, Laura Magrini, Andrea Kazemi Nava, Andrea Scarinci, Marco La Torre, Mario Ferri, Enrico Ferri, Niccolò Petrucciani, Vincenzo Ziparo

Published in: World Journal of Surgery | Issue 1/2012

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Abstract

Background

Cardiovascular disease is the leading cause of perioperative death in surgical patients. A variety of clinical scoring systems have been developed to predict adverse cardiovascular events. B-type natriuretic peptide (BNP) is a sensitive and specific predictor of left ventricular systolic dysfunction and predicts first cardiovascular event and death in the general population. We present a prospective, single-center, observational cohort study of patients undergoing major abdominal surgery and evaluate the role of BNP in predicting adverse cardiac events.

Method

A total of 205 patients were included in the study. All patients were assessed by a cardiological clinical evaluation, a 12-lead ECG report, and a preoperative and postoperative blood sample for plasmatic BNP assessment. The primary end point was the predictive power of preoperative BNP levels for adverse cardiac events until 30 days after discharge.

Results

Thirty-one of 205 (15%) patients had adverse cardiac events in the postoperative period up to 30 days after discharge. Five patients (2.4%) of these died of cardiac events. Preoperative BNP values were significantly increased in the 31 patients compared to the other patients in the postoperative period [mean = 112.93 pg/ml (range = 5–2,080) vs. 178.99 pg/ml (range = 5–3,980); median = 117 vs. 23 pg/ml; 95% CI = 49–181; p < 0.0001]. At logistic regression, a preoperative BNP value of >36 pg/ml was the only effective predictor of adverse cardiac events.

Conclusion

We have demonstrated that elevated preoperative BNP levels are independent predictors of adverse cardiac events in a cohort of patients undergoing major abdominal surgery in a general surgery department, and this is the first study about this specific cohort of patients.
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Metadata
Title
Preoperative Brain Natriuretic Peptide (BNP) Is a Better Predictor of Adverse Cardiac Events Compared to Preoperative Scoring System in Patients Who Underwent Abdominal Surgery
Authors
Paolo Mercantini
Salvatore Di Somma
Laura Magrini
Andrea Kazemi Nava
Andrea Scarinci
Marco La Torre
Mario Ferri
Enrico Ferri
Niccolò Petrucciani
Vincenzo Ziparo
Publication date
01-01-2012
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 1/2012
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-011-1354-6

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