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B-Type Natriuretic Peptide as a Predictor of Postoperative Heart Failure After Aortic Valve Replacement.

Nozohoor, Shahab LU ; Nilsson, Johan LU ; Lührs, Carsten LU ; Roijer, Anders LU ; Algotsson, Lars LU and Sjögren, Johan LU (2009) In Journal of Cardiothoracic and Vascular Anesthesia 23. p.161-165
Abstract
OBJECTIVE: B-type natriuretic peptide (BNP) has been established as a biomarker for heart failure. The objective was to evaluate BNP measured on arrival in the intensive care unit (ICU) as a predictor for heart failure defined as need for inotropic support or IABP beyond 24 hours postoperatively after aortic valve replacement. DESIGN: A prospective, observational study. SETTING: A cardiothoracic surgery unit at a tertiary level hospital. PARTICIPANTS: One hundred sixty-one patients undergoing aortic valve replacement. MEASUREMENTS AND MAIN RESULTS: Two levels of BNP were evaluated: the median (BNP >133 pg/mL) and a cutoff (BNP >82 pg/mL) based on receiver-operating characteristic (ROC) analysis. Uni- and multivariate analysis were... (More)
OBJECTIVE: B-type natriuretic peptide (BNP) has been established as a biomarker for heart failure. The objective was to evaluate BNP measured on arrival in the intensive care unit (ICU) as a predictor for heart failure defined as need for inotropic support or IABP beyond 24 hours postoperatively after aortic valve replacement. DESIGN: A prospective, observational study. SETTING: A cardiothoracic surgery unit at a tertiary level hospital. PARTICIPANTS: One hundred sixty-one patients undergoing aortic valve replacement. MEASUREMENTS AND MAIN RESULTS: Two levels of BNP were evaluated: the median (BNP >133 pg/mL) and a cutoff (BNP >82 pg/mL) based on receiver-operating characteristic (ROC) analysis. Uni- and multivariate analysis were performed to identify predictors of postoperative heart failure. Patients with postoperative heart failure (n = 37) showed a more than 10-fold increase in 30-day mortality (8.1%, 3/37) compared with patients without postoperative heart failure (0.8%, 1/124) (p = 0.038). Elevated postoperative BNP levels were identified as an independent predictor of postoperative heart failure: BNP >82 pg/mL (p = 0.004) and BNP >133 pg/mL (p = 0.013). The area under the ROC curve for BNP as a predictor of postoperative heart failure was 0.69. CONCLUSION: Postoperative heart failure after aortic valve replacement is still a very serious condition with increased early mortality. The results of the present study suggest that an elevated BNP level on arrival in the ICU is an independent predictor of postoperative heart failure after aortic valve replacement. In the authors' opinion, an increased BNP level on arrival in the ICU may support early diagnosis and allow optimal management of heart failure after aortic valve replacement. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
in
Journal of Cardiothoracic and Vascular Anesthesia
volume
23
pages
161 - 165
publisher
W B Saunders
external identifiers
  • wos:000264999500006
  • pmid:19167912
  • scopus:62549110802
ISSN
1532-8422
DOI
10.1053/j.jvca.2008.11.006
language
English
LU publication?
yes
id
7285a48e-edd8-4ed3-853f-c701ddfec13d (old id 1289285)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19167912?dopt=Abstract
date added to LUP
2009-02-06 13:07:55
date last changed
2017-04-02 04:13:39
@article{7285a48e-edd8-4ed3-853f-c701ddfec13d,
  abstract     = {OBJECTIVE: B-type natriuretic peptide (BNP) has been established as a biomarker for heart failure. The objective was to evaluate BNP measured on arrival in the intensive care unit (ICU) as a predictor for heart failure defined as need for inotropic support or IABP beyond 24 hours postoperatively after aortic valve replacement. DESIGN: A prospective, observational study. SETTING: A cardiothoracic surgery unit at a tertiary level hospital. PARTICIPANTS: One hundred sixty-one patients undergoing aortic valve replacement. MEASUREMENTS AND MAIN RESULTS: Two levels of BNP were evaluated: the median (BNP >133 pg/mL) and a cutoff (BNP >82 pg/mL) based on receiver-operating characteristic (ROC) analysis. Uni- and multivariate analysis were performed to identify predictors of postoperative heart failure. Patients with postoperative heart failure (n = 37) showed a more than 10-fold increase in 30-day mortality (8.1%, 3/37) compared with patients without postoperative heart failure (0.8%, 1/124) (p = 0.038). Elevated postoperative BNP levels were identified as an independent predictor of postoperative heart failure: BNP >82 pg/mL (p = 0.004) and BNP >133 pg/mL (p = 0.013). The area under the ROC curve for BNP as a predictor of postoperative heart failure was 0.69. CONCLUSION: Postoperative heart failure after aortic valve replacement is still a very serious condition with increased early mortality. The results of the present study suggest that an elevated BNP level on arrival in the ICU is an independent predictor of postoperative heart failure after aortic valve replacement. In the authors' opinion, an increased BNP level on arrival in the ICU may support early diagnosis and allow optimal management of heart failure after aortic valve replacement.},
  author       = {Nozohoor, Shahab and Nilsson, Johan and Lührs, Carsten and Roijer, Anders and Algotsson, Lars and Sjögren, Johan},
  issn         = {1532-8422},
  language     = {eng},
  pages        = {161--165},
  publisher    = {W B Saunders},
  series       = {Journal of Cardiothoracic and Vascular Anesthesia},
  title        = {B-Type Natriuretic Peptide as a Predictor of Postoperative Heart Failure After Aortic Valve Replacement.},
  url          = {http://dx.doi.org/10.1053/j.jvca.2008.11.006},
  volume       = {23},
  year         = {2009},
}