Preoperative Biomarker Levels May Predict Cardiac Events

Findings suggest high levels linked to adverse outcomes one month post non-cardiac surgery
By A. Agrawal, PhD
HealthDay Reporter

TUESDAY, Oct. 13 (HealthDay News) -- Patients with high preoperative levels of brain natriuretic peptide (BNP) or N-terminal pro-B-type natriuretic peptide (NT-proBNP) may be at a higher risk of adverse cardiovascular outcomes within 30 days of non-cardiac surgery, according to a systematic review published in the Oct. 20 issue of the Journal of the American College of Cardiology.

Ganesan Karthikeyan, M.D., of All India Institute of Medical Sciences in New Delhi, and colleagues identified and performed a meta-analysis of nine studies, including a total of 3,281 patients, that investigated the independent prognostic value of preoperative BNP levels as a predictor of cardiovascular complications one month after non-cardiac surgery.

The researchers found that 314 patients had experienced perioperative cardiovascular complications and an average of 24.8 percent of patients had elevated BNP levels. All studies showed a strong association between elevated preoperative BNP and adverse cardiovascular outcomes. In addition, elevated preoperative BNP was an independent predictor of perioperative cardiovascular events, both in studies that considered the outcomes of death, cardiovascular death or myocardial infarction, and in studies that considered other end points.

"This systematic review and meta-analysis suggests that a preoperative BNP or NT-proBNP concentration is a powerful, independent predictor of cardiovascular events in the first 30 days after non-cardiac surgery," the researchers conclude. "This test appears to represent a rapid and relatively inexpensive method to enhance preoperative cardiovascular risk prediction."

One author reported financial support from Roche Diagnostics.

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