Predictors of mortality in cardiac surgery: brain natriuretic peptide type B

Rev Bras Cir Cardiovasc. Mar-Apr 2015;30(2):182-7. doi: 10.5935/1678-9741.20150008.

Abstract

Objective: We evaluated whether the preoperative serum concentration of brain natriuretic peptide (BNP) is a predictor of in-hospital mortality in patients that underwent cardiac surgery.

Methods: We continuously evaluated 488 patients that underwent cardiac valve surgery or coronary artery bypass grafting (CABG) between January of 2009 and July of 2012. Follow up of these patients were done prospectively for 30 days postoperatively.

Results: Data analysis showed that the overall mortality rate was equal to 9.6%, Receiver Operating Charactheristic (ROC) curve analysis found the optimal cut-off value of BNP equal to 382 pg/mL for overall mortality (AUC=0.73, 95% CI=0.66 to 0.81, P<0.001). Multivariate analysis showed that the value of BNP higher than 382 pg/mL (P=0.033, HR=2.05, 95% CI=1.6 to 3.98) was an independent predictor of overall mortality at 30 days postoperatively.

Conclusion: We concluded that the preoperative serum concentration of BNP is an independent predictor of mortality in patients undergoing valve surgery or coronary artery bypass graft.

Objetivo: Avaliar se a concentração sérica pré-operatória de peptídeo natriurético cerebral tipo B (BNP) é preditora de mortalidade intra-hospitalar em pacientes submetidos à cirurgia cardíaca.

Métodos: Foram avaliados 488 pacientes consecutivamente submetidos à cirurgia cardíaca valvar ou à cirurgia de revascularização do miocárdio no período de janeiro de 2009 a julho de 2012. Estes foram seguidos, prospectivamente, por 30 dias de pós-operatório.

Resultados: Em nossa casuística, a mortalidade geral foi igual a 9,6% e 52% dos pacientes foram submetidos a cirurgia de revascularização do miocárdio. Análise de curva ROC (Receiver Operating Charactheristic) encontrou o valor de corte ótimo de BNP igual a 382 pg/mL para mortalidade geral (AUC=0,73, IC95%=0.66 a 0,81, P<0.001). Análise multivariada mostrou que o valor de BNP > 382 pg/mL (P=0,033, HR=2,05, IC 95%=1,06 a 3,98) foi preditor independente de mortalidade geral em 30 dias de pós-operatório.

Conclusão: A concentração sérica pré-operatória do BNP é um preditor independente de mortalidade em pacientes submetidos à cirurgia valvar ou de revascularização do miocárdio.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Biomarkers / blood
  • Coronary Artery Bypass / mortality*
  • Epidemiologic Methods
  • Female
  • Heart Valve Diseases / mortality*
  • Heart Valve Diseases / surgery*
  • Hospital Mortality*
  • Humans
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood*
  • Postoperative Period
  • Reference Values
  • Risk Assessment / methods
  • Time Factors
  • Treatment Outcome

Substances

  • Biomarkers
  • Natriuretic Peptide, Brain