Perioperative Levels of Troponin and BNP and the Outcome after Coronary Artery Bypass Grafting.

IF 0.7 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Heart Surgery Forum Pub Date : 2023-05-31 DOI:10.1532/hsf.5471
Ayman R Abdelrehim, Faisal A Alnasser, Fareed A Alnozaha, Mohammadnizam S H Uddin, Hasan I Sandogji, Hussain R Aynusah, Asim S S Alluhaybi, Refal A Alahmadi, Hussam M Alahmadi, Wafaa M Alharbi, Ahmed M Shabaan
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Abstract

Background: The independent predictive values of troponin I (cTnI) and B-type natriuretic peptide (BNP) after coronary artery bypass grafting (CABG) have been reported in several studies. However, adjustment only has been limited to preoperative risk factors.

Aim: This study was conducted to assess the independent values of postoperative cTnI and BNP to predict the outcome after CABG with adjustment for preoperative risk estimates and postoperative complications and to report risk stratification gains, when considering the European System for Cardiac Operative Risk Evaluation (EuroSCORE) combined with postoperative biomarkers.

Methods: This retrospective cohort study included 282 consecutive patients undergoing CABG between January 2018 and December 2021. We evaluated the preoperative and postoperative cTnI and BNP, EuroSCORE, and postoperative complications. The composite endpoint was death or cardiac-related adverse events.

Results: The AUROC for postoperative cTnI was significantly higher than that of BNP (0.777 vs. 0.625, p = 0.041). The optimal cut-off values to predict the composite outcome were >4830 (pg/mL) and >6.95 (ng/mL) for BNP and cTnI, respectively. Adjustment for relevant and significant perioperative factors showed that postoperative BNP and cTnI had a high discriminatory power (C-index = 0.773 and 0.895, respectively) for predicting major adverse events.

Conclusions: Postoperative BNP and cTnI are independent predictors of death or major adverse events, following CABG, and can add to the predictive power of EuroSCORE II.

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冠状动脉搭桥术围手术期肌钙蛋白和脑钠肽水平与预后的关系。
背景:一些研究报道了冠状动脉旁路移植术(CABG)后肌钙蛋白I (cTnI)和b型利钠肽(BNP)的独立预测价值。然而,调整仅限于术前危险因素。目的:本研究旨在评估术后cTnI和BNP的独立价值,在考虑欧洲心脏手术风险评估系统(EuroSCORE)联合术后生物标志物的情况下,在调整术前风险估计和术后并发症的情况下预测CABG后的预后,并报告风险分层收益。方法:本回顾性队列研究包括282例2018年1月至2021年12月期间连续接受CABG的患者。我们评估了术前和术后cTnI和BNP, EuroSCORE以及术后并发症。复合终点为死亡或心脏相关不良事件。结果:术后cTnI的AUROC明显高于BNP(0.777比0.625,p = 0.041)。预测复合结果的最佳临界值分别为BNP >4830 (pg/mL)和cTnI >6.95 (ng/mL)。校正围手术期相关及重要因素后发现,术后BNP和cTnI对预测主要不良事件具有较高的判别力(C-index分别为0.773和0.895)。结论:术后BNP和cTnI是冠脉搭桥后死亡或主要不良事件的独立预测因子,可增加EuroSCORE II的预测能力。
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来源期刊
Heart Surgery Forum
Heart Surgery Forum 医学-外科
CiteScore
1.20
自引率
16.70%
发文量
130
审稿时长
6-12 weeks
期刊介绍: The Heart Surgery Forum® is an international peer-reviewed, open access journal seeking original investigative and clinical work on any subject germane to the science or practice of modern cardiac care. The HSF publishes original scientific reports, collective reviews, case reports, editorials, and letters to the editor. New manuscripts are reviewed by reviewers for originality, content, relevancy and adherence to scientific principles in a double-blind process. The HSF features a streamlined submission and peer review process with an anticipated completion time of 30 to 60 days from the date of receipt of the original manuscript. Authors are encouraged to submit full color images and video that will be included in the web version of the journal at no charge.
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