02546nas a2200265   4500000000100000008004100001100001300042700001400055700001900069700001700088700001400105700001500119700001400134700001600148700001800164700001600182700001300198700001100211245012100222250001500343300001100358490000800369520185700377020004602234       2009                            d1 aCroal B.1 aGibson P.1 aCuthbertson B.1 aEl-Shafei H.1 aGibson G.1 aJeffrey R.1 aBuchan K.1 aMcNeilly J.1 aHillis Graham1 aPrescott G.1 aSmith W.1 aRae D.00aN-terminal pro-B-type natriuretic peptide levels and early outcome after cardiac surgery: a prospective cohort study  a2009/08/29  a647-530 v1033 a<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>
  a1471-6771 (Electronic)0007-0912 (Linking)