Association of N-terminal pro-brain natriuretic peptide and cardiac troponin T with in-hospital cardiac events in elderly patients undergoing coronary artery surgery.

Eur J Anaesthesiol

Klinikum der Stadt Ludwigshafen, Department of Anaesthesiology and Intensive Care Medicine, Ludwigshafen, Germany.

Published: October 2008

Background And Objectives: Despite evidence of their prognostic power for non-surgical patients, the value of perioperative natriuretic peptides and cardiac troponins as markers of cardiac events is incompletely defined. This study sought to examine whether perioperative N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin T (cTnT) levels could be used for the prediction of in-hospital cardiac events in elderly patients undergoing elective coronary artery bypass grafting.

Methods: Ninety-eight elderly patients (>75 yr) undergoing elective coronary artery bypass grafting with cardiopulmonary bypass were enrolled and followed up for 121 and 0.66 1 for NT-proBNP and cTnT (sensitivity, specificity, positive predictive value and negative predictive value of 84.3%, 89.4%, 78.9% and 92.4%, and 93.7%, 74.2%, 63.8% and 96.1%, respectively) at 24 h after surgery to be associated with in-hospital cardiac events. An elevation of both biomarkers above these threshold values was independently associated with individual postoperative complications (odds ratio, 18.9; 95%, CI, 2.3-106.1).

Conclusions: In elderly patients undergoing elective coronary artery bypass grafting surgery, high values of NT-proBNP and cTnT measured 24 h after the end of surgery were independently associated with in-hospital cardiac events.

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http://dx.doi.org/10.1017/S0265021508004365DOI Listing

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