@article{17345,
  author = {Croal B. and Gibson P. and Cuthbertson B. and El-Shafei H. and Gibson G. and Jeffrey R. and Buchan K. and McNeilly J. and Hillis Graham and Prescott G. and Smith W. and Rae D.},
  title = {N-terminal pro-B-type natriuretic peptide levels and early outcome after cardiac surgery: a prospective cohort study},
  abstract = {<p>
BACKGROUND: N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a powerful predictor of cardiovascular outcome in many circumstances. There are, however, limited data regarding the utility of NT-proBNP or BNP levels in patients undergoing cardiac surgery. The current study assesses the ability of NT-proBNP to predict early outcome in this setting. METHODS: One thousand and ten patients undergoing non-emergent cardiac surgery were recruited prospectively. Baseline clinical details were obtained and the European System for Cardiac Operative Risk Evaluation (EuroSCORE) and Parsonnet score were calculated. Preoperative NT-proBNP levels were measured using the Roche Elecsys assay. The primary endpoint was 30 day mortality. RESULTS: Median NT-proBNP levels were 624 ng litre(-1) among patients who died within 30 days of surgery (n=29), compared with 279 ng litre(-1) in survivors [odds ratio (OR) 1.03 per 250 ng litre(-1), 95% confidence interval 1.01-1.05, P=0.001). NT-proBNP levels remained predictors of 30 day mortality in models including either the additive EuroSCORE (OR 1.03 per 250 ng litre(-1), P=0.01), the logistic EuroSCORE (OR 1.03 per 250 ng litre(-1), P=0.004), or the Parsonnet score (OR 1.02 per 250 ng litre(-1), P=0.04). Levels of NT-proBNP were also predictors of prolonged (&gt;1 day) stay in the intensive care unit (OR 1.03 per 250 ng litre(-1), P&lt;0.001) and of a hospital stay &gt;1 week (OR 1.07 per 250 ng litre(-1), P&lt;0.001). They remained predictive of these outcomes in regression models that included either the EuroSCORE or the Parsonnet score and in a model that included all study variables. CONCLUSIONS: NT-proBNP levels predict early outcome after cardiac surgery. Their prognostic utility is modest-but is independent of traditional indicators and conventional risk prediction scores.
</p>
},
  year = {2009},
  journal = {British Journal of Anaesthesia},
  volume = {103},
  edition = {2009/08/29},
  number = {5},
  pages = {647-53},
  isbn = {1471-6771 (Electronic)0007-0912 (Linking)},
  note = {Cuthbertson, B HCroal, B LRae, DGibson, P HMcNeilly, J DJeffrey, R RSmith, W CairnsPrescott, G JBuchan, K GEl-Shafei, HGibson, G AHillis, G SBritish Heart Foundation/United KingdomEvaluation StudiesResearch Support, Non-U.S. Gov'tEnglandBritish journal of anaesthesiaBr J Anaesth. 2009 Nov;103(5):647-53. Epub 2009 Aug 27.},
  language = {eng},
}