Ayman R Abdelrehim, Faisal A Alnasser, Fareed A Alnozaha, Mohammadnizam S H Uddin, Hasan I Sandogji, Hussain R Aynusah, Asim S S Alluhaybi, Refal A Alahmadi, Hussam M Alahmadi, Wafaa M Alharbi, Ahmed M Shabaan
{"title":"冠状动脉搭桥术围手术期肌钙蛋白和脑钠肽水平与预后的关系。","authors":"Ayman R Abdelrehim, Faisal A Alnasser, Fareed A Alnozaha, Mohammadnizam S H Uddin, Hasan I Sandogji, Hussain R Aynusah, Asim S S Alluhaybi, Refal A Alahmadi, Hussam M Alahmadi, Wafaa M Alharbi, Ahmed M Shabaan","doi":"10.1532/hsf.5471","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The independent predictive values of troponin I (cTnI) and B-type natriuretic peptide (BNP) after coronary artery bypass grafting (CABG) have been reported in several studies. However, adjustment only has been limited to preoperative risk factors.</p><p><strong>Aim: </strong>This study was conducted to assess the independent values of postoperative cTnI and BNP to predict the outcome after CABG with adjustment for preoperative risk estimates and postoperative complications and to report risk stratification gains, when considering the European System for Cardiac Operative Risk Evaluation (EuroSCORE) combined with postoperative biomarkers.</p><p><strong>Methods: </strong>This retrospective cohort study included 282 consecutive patients undergoing CABG between January 2018 and December 2021. We evaluated the preoperative and postoperative cTnI and BNP, EuroSCORE, and postoperative complications. The composite endpoint was death or cardiac-related adverse events.</p><p><strong>Results: </strong>The AUROC for postoperative cTnI was significantly higher than that of BNP (0.777 vs. 0.625, p = 0.041). The optimal cut-off values to predict the composite outcome were >4830 (pg/mL) and >6.95 (ng/mL) for BNP and cTnI, respectively. Adjustment for relevant and significant perioperative factors showed that postoperative BNP and cTnI had a high discriminatory power (C-index = 0.773 and 0.895, respectively) for predicting major adverse events.</p><p><strong>Conclusions: </strong>Postoperative BNP and cTnI are independent predictors of death or major adverse events, following CABG, and can add to the predictive power of EuroSCORE II.</p>","PeriodicalId":51056,"journal":{"name":"Heart Surgery Forum","volume":"26 3","pages":"E240-E248"},"PeriodicalIF":0.7000,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Perioperative Levels of Troponin and BNP and the Outcome after Coronary Artery Bypass Grafting.\",\"authors\":\"Ayman R Abdelrehim, Faisal A Alnasser, Fareed A Alnozaha, Mohammadnizam S H Uddin, Hasan I Sandogji, Hussain R Aynusah, Asim S S Alluhaybi, Refal A Alahmadi, Hussam M Alahmadi, Wafaa M Alharbi, Ahmed M Shabaan\",\"doi\":\"10.1532/hsf.5471\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The independent predictive values of troponin I (cTnI) and B-type natriuretic peptide (BNP) after coronary artery bypass grafting (CABG) have been reported in several studies. However, adjustment only has been limited to preoperative risk factors.</p><p><strong>Aim: </strong>This study was conducted to assess the independent values of postoperative cTnI and BNP to predict the outcome after CABG with adjustment for preoperative risk estimates and postoperative complications and to report risk stratification gains, when considering the European System for Cardiac Operative Risk Evaluation (EuroSCORE) combined with postoperative biomarkers.</p><p><strong>Methods: </strong>This retrospective cohort study included 282 consecutive patients undergoing CABG between January 2018 and December 2021. We evaluated the preoperative and postoperative cTnI and BNP, EuroSCORE, and postoperative complications. The composite endpoint was death or cardiac-related adverse events.</p><p><strong>Results: </strong>The AUROC for postoperative cTnI was significantly higher than that of BNP (0.777 vs. 0.625, p = 0.041). The optimal cut-off values to predict the composite outcome were >4830 (pg/mL) and >6.95 (ng/mL) for BNP and cTnI, respectively. Adjustment for relevant and significant perioperative factors showed that postoperative BNP and cTnI had a high discriminatory power (C-index = 0.773 and 0.895, respectively) for predicting major adverse events.</p><p><strong>Conclusions: </strong>Postoperative BNP and cTnI are independent predictors of death or major adverse events, following CABG, and can add to the predictive power of EuroSCORE II.</p>\",\"PeriodicalId\":51056,\"journal\":{\"name\":\"Heart Surgery Forum\",\"volume\":\"26 3\",\"pages\":\"E240-E248\"},\"PeriodicalIF\":0.7000,\"publicationDate\":\"2023-05-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Heart Surgery Forum\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1532/hsf.5471\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart Surgery Forum","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1532/hsf.5471","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Perioperative Levels of Troponin and BNP and the Outcome after Coronary Artery Bypass Grafting.
Background: The independent predictive values of troponin I (cTnI) and B-type natriuretic peptide (BNP) after coronary artery bypass grafting (CABG) have been reported in several studies. However, adjustment only has been limited to preoperative risk factors.
Aim: This study was conducted to assess the independent values of postoperative cTnI and BNP to predict the outcome after CABG with adjustment for preoperative risk estimates and postoperative complications and to report risk stratification gains, when considering the European System for Cardiac Operative Risk Evaluation (EuroSCORE) combined with postoperative biomarkers.
Methods: This retrospective cohort study included 282 consecutive patients undergoing CABG between January 2018 and December 2021. We evaluated the preoperative and postoperative cTnI and BNP, EuroSCORE, and postoperative complications. The composite endpoint was death or cardiac-related adverse events.
Results: The AUROC for postoperative cTnI was significantly higher than that of BNP (0.777 vs. 0.625, p = 0.041). The optimal cut-off values to predict the composite outcome were >4830 (pg/mL) and >6.95 (ng/mL) for BNP and cTnI, respectively. Adjustment for relevant and significant perioperative factors showed that postoperative BNP and cTnI had a high discriminatory power (C-index = 0.773 and 0.895, respectively) for predicting major adverse events.
Conclusions: Postoperative BNP and cTnI are independent predictors of death or major adverse events, following CABG, and can add to the predictive power of EuroSCORE II.
期刊介绍:
The Heart Surgery Forum® is an international peer-reviewed, open access journal seeking original investigative and clinical work on any subject germane to the science or practice of modern cardiac care. The HSF publishes original scientific reports, collective reviews, case reports, editorials, and letters to the editor. New manuscripts are reviewed by reviewers for originality, content, relevancy and adherence to scientific principles in a double-blind process. The HSF features a streamlined submission and peer review process with an anticipated completion time of 30 to 60 days from the date of receipt of the original manuscript. Authors are encouraged to submit full color images and video that will be included in the web version of the journal at no charge.