术前脑利钠肽和心肌肌钙蛋白I在预测老年非心脏手术患者围手术期主要不良心血管事件中的应用

IF 0.2 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Research in Cardiovascular Medicine Pub Date : 2023-01-01 DOI:10.4103/rcm.rcm_18_23
Sujay Renga, AnakhaAbdul Shereef Sabiathu Beevi
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引用次数: 0

摘要

背景:重大不良心血管事件(mace)在接受非心脏手术的患者中经常遇到。本研究评估了心肌肌钙蛋白I (cTnI)和脑利钠肽(BNP)在预测老年(≥60岁)非心脏手术患者MACE中的应用。方法:这项比较横断面研究于2016年11月至2018年8月在印度的一家三级医疗中心进行。在外科、骨科或妇科接受全身/脊柱/区域麻醉的非心脏手术的136例连续患者(年龄≥60岁)被纳入研究。慢性肾脏疾病4期和5期患者以及因肾衰竭而接受血液透析或腹膜透析的患者被排除在研究之外。术前24 h内取外周血BNP和cTnI检测。主要终点是MACE的发生,MACE定义为术后6天心脏死亡、非致死性心肌梗死、心力衰竭、心律失常和心脏骤停的综合情况。结果:患者平均年龄69.41±7.56岁。女性占研究人群的54.1%。围手术期及随访6 d,共记录MACE 12例。MACE患者术前cTnI水平单独升高或cTnI和BNP水平同时升高(cTnI水平>0.07 ng/mL, BNP水平>40 pg/mL),差异均有统计学意义(P < 0.05)。cTnI和BNP预测围手术期心脏事件的受试者工作特征曲线下面积为0.817(95%可信区间[CI] 0.646-0.988;P < 0.001)和0.520 (95% CI 0.337-0.704;P = 0.817)。结论:在接受非心脏手术的老年患者中,术前评估BNP和cTnI可能有助于评估MACE。
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Utility of preoperative brain natriuretic peptide and cardiac troponin I in predicting perioperative major adverse cardiovascular events in elderly patients undergoing noncardiac surgery
Background: Major adverse cardiovascular events (MACEs) are frequently encountered in patients undergoing noncardiac surgeries. This study evaluated the utility of cardiac troponin I (cTnI) and brain natriuretic peptide (BNP) to predict MACE in elderly patients (aged ≥60 years) undergoing noncardiac surgeries. Methods: This comparative cross-sectional study was carried out at a tertiary care center in India between November 2016 and August 2018. A total of 136 consecutive patients (aged ≥60 years) presenting for noncardiac surgeries under general/spinal/regional anesthesia in the departments of surgery, orthopedics, or gynecology were included in the study. Patients with chronic kidney disease stages 4 and 5 and those receiving hemodialysis or peritoneal dialysis for renal failure were excluded from the study. Peripheral blood samples for BNP and cTnI were obtained within 24 h preoperatively. The primary endpoint was the occurrence of MACE, defined as the composite of cardiac death, nonfatal myocardial infarction, heart failure, arrhythmias, and cardiac arrest at 6 days postsurgery. Results: The mean age of patients was 69.41 ± 7.56 years. Females comprised 54.1% of the study population. During the perioperative period and follow-up of 6 days, 12 MACE were recorded. Preoperative cTnI levels alone or both cTnI and BNP together (cTnI levels >0.07 ng/mL and BNP levels >40 pg/mL) increased significantly in the patients who experienced MACE (P < 0.05). The area under receiver operating characteristics curve for cTnI and BNP for predicting perioperative cardiac events was 0.817 (95% confidence interval [CI] 0.646–0.988; P < 0.001) and 0.520 (95% CI 0.337–0.704; P = 0.817), respectively. Conclusions: In elderly patients undergoing noncardiac surgeries, a preoperative assessment of BNP and cTnI may help in the assessment of MACE.
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Research in Cardiovascular Medicine
Research in Cardiovascular Medicine CARDIAC & CARDIOVASCULAR SYSTEMS-
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审稿时长
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