Aminoterminal B-type Pro–Natriuretic Peptide as a Marker of Recovery After High-risk Coronary Artery Bypass Grafting in Patients With Ischemic Heart Disease and Severe Impaired Left Ventricular Function

Rothenburger, Markus; Stypmann, Jörg; Bruch, Christian; Wichter, Thomas; Hoppe, Matthias; Drees, G.; Berendes, Elmar; Huelsken, G.; Loeher, Andreas; Welp, Henryk; Röttger, Carina; Schmid, Çhristof; Scheld, Hans H.; Tjan, T. D. T.

doi:10.1016/j.healun.2005.12.006

Cited by 8 publications

(4 citation statements)

References 31 publications

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“…The HF survival score was calculated as described previously. 11 Measurements of peak VO 2 were performed during maximal treadmill exercise. Ultrasound parameters such as left ventricular end-diastolic diameter (LVEDD), fractional shortening (FS), and EF were determined by echocardiography as recommended by the American Society of Echocardiography.…”

Section: Methodsmentioning

confidence: 99%

Atorvastatin Therapy Is Associated with Reduced Levels of N‐terminal Prohormone Brain Natriuretic Peptide and Improved Cardiac Function in Patients with Heart Failure

Stypmann

Schubert²,

Welp³

et al. 2008

Clinical Cardiology

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BackgroundStatins have been suggested to improve cardiac function, but the evidence underlying beneficial effects of statins in heart failure (HF) is insufficient. We analyzed plasma N‐terminal prohormone brain natriuretic peptide (NT‐proBNP) levels and cardiac function in patients with HF of various etiologies, and who were treated with or without statins.HypothesisStatin treatment is associated with improved cardiac function in HF.MethodsThe study cohort consisted of 139 consecutive male patients receiving atorvastatin (n = 44), simvastatin (n = 29), pravastatin (n = 19), or no statin (n = 47). The NT‐proBNP levels were measured using electroluminescence immunoassay. Left ventricular end‐diastolic diameter (LVEDD), fractional shortening (FS), and ejection fraction (EF) were determined by echocardiography.ResultsPatients receiving atorvastatin presented with reduced NT‐proBNP levels (1,552 ± 3,416 versus 3,771 ± 6,763 pg/mL; p < 0.01), and improved values of LVEDD (65.2 ± 8.9 versus 70.7 ± 10.9 mm; p < 0.05) and EF (33.2 ± 12.6 versus 28.2 ± 9.6%; p < 0.05). By contrast, plasma NT‐proBNP and cardiac parameters in patients treated with statins other than atorvastatin did not significantly differ from control. Atorvastatin treatment was equally effective in patients with ischemic and nonischemic HF.ConclusionsAtorvastatin treatment is associated with improved cardiac function in HF, and may represent an additional option for patients with this disease. Copyright © 2008 Wiley Periodicals, Inc.

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Section: Methodsmentioning

confidence: 99%

Atorvastatin Therapy Is Associated with Reduced Levels of N‐terminal Prohormone Brain Natriuretic Peptide and Improved Cardiac Function in Patients with Heart Failure

Stypmann

Schubert²,

Welp³

et al. 2008

Clinical Cardiology

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“…18 Plasma NTproBNP is a useful marker for recovery after a high-risk CABG procedure, and conversely significantly correlated with LVEF, and it increases as the LVEF declines. 19,20 In our study we found the LVEF value was statistically significantly higher in Group A than in Group B. The NTproBNP level can identify patients with symptoms of heart failure and LVEF ≤40% with a sensitivity of 0.92 and specificity of 0.86.…”

Section: Discussionmentioning

confidence: 49%

N-Terminal ProBNP Levels Can Predict Cardiac Failure After Cardiac Surgery

Cerrahoğlu

Işkesen

Tekin

et al. 2007

Circ J

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ardiac failure has a prevalence of 1% in people aged in their 50 s and 10% in their 80 s. The presence of cardiac failure symptoms in the preoperative period is known to increase the surgical risk and the postoperative mortality and morbidity. In recent years the introduction of new drugs and the increased use of coronary angioplasty and stent methods have enabled coronary heart operations to be performed in older patients and patients with late-stage disease. Thus determination of patient risk prior to operation has acquired importance.The plasma B-type natriuretic peptide (BNP) level varies according to the grade of heart failure; that is, it progressively increases from Grade I to Grade IV of the New York Heart Association classification and this increase in the secretion of natriuretic peptides is closely associated with left ventricular (LV) wall tension and ventricular filling pressure. 1 BNP, which is secreted because of increased LV wall tension, and its aminoterminal fraction N-terminal (NT)-proBNP, have gained a high value with respect to predicting LV function and its prognosis. 2,3 Of the natriuretic peptides, NT-proBNP particularly is accepted as a specific marker of cardiac failure 4 and in cases where the NT-proBNP level has increased above approximately 200 pg/ml, a diagnosis of cardiac failure may be made if there are also concomitant signs of cardiac failure. 5 Studies of the relationship between the severity of the heart failure after cardiac surgery and the requirement for inotropic agent, as related to the predictive use of NT-proBNP, are limited in the literature. Circulation Journal Vol.71, January 2007In the present study, the association between the preoperative NT-proBNP level and the prevalance and level of cardiac failure in the early postoperative period in patients undergoing coronary artery bypass grafting (CABG) was investigated. MethodsWe enrolled 52 adult patients undergoing elective CABG. In all patients the NT-proBNP level was measured via Elecys ProBNP sandwich immunoassay method on the day before surgery, and the normal value was accepted as <220 pg/ml. 6 Based on this we divided the patients into 2 groups: NT-proBNP level <220 pg/ml (Group A, n=26) or >220 pg/ml (Group B, n=26). Patients with renal failure (because a preoperative creatinine level >1.6 would cause an increase in the NT-proBNP level), acute myocardial infarction, or combined valvular disease and severe obstructive pulmonary disease were excluded.All the patients underwent CABG with standard cardiopulmonary bypass (CPB) techniques. The left internal mammary artery was used for revascularizing the left anterior descending coronary artery or a saphenous vein graft was used for the other coronary arteries. Arterial pressure was monitored via a radial artery cannula and cardiac rhythm was followed by the bedside monitor. The values for cardiac output (CO) and cardiac index (CI), pulmonary capillary wedge pressure (PCWP), pulmonary artery pressure (PAP), central venous pressure (CVP) were measured preoperatively an...

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“…Preoperative levels of its sister compound, brain natriuretic peptide (BNP), have been used to predict postoperative mortality in patients undergoing cardiac surgery procedures, including CABG 41, 42. Additionally, studies on patients undergoing isolated CABG found associations between preoperative levels of NT‐ProBNP and postoperative mortality, prompting inclusion of preoperative levels of the biomarker into our models 16, 43, 44…”

Section: Discussionmentioning

confidence: 99%

Predictive Ability of Novel Cardiac Biomarkers ST2, Galectin‐3, and NT‐ProBNP Before Cardiac Surgery

Polineni

Parker

Alam

et al. 2018

JAHA

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BackgroundCurrent preoperative models use clinical risk factors alone in estimating risk of in‐hospital mortality following cardiac surgery. However, novel biomarkers now exist to potentially improve preoperative prediction models. An assessment of Galectin‐3, N‐terminal pro b‐type natriuretic peptide (NT‐ProBNP), and soluble ST2 to improve the predictive ability of an existing prediction model of in‐hospital mortality may improve our capacity to risk‐stratify patients before surgery.Methods and ResultsWe measured preoperative biomarkers in the NNECDSG (Northern New England Cardiovascular Disease Study Group), a prospective cohort of 1554 patients undergoing coronary artery bypass graft surgery. Exposures of interest were preoperative levels of galectin‐3, NT‐ProBNP, and ST2. In‐hospital mortality and adverse events occurring after coronary artery bypass graft were the outcomes. After adjustment, NT‐ProBNP and ST2 showed a statistically significant association with both their median and third tercile categories with NT‐ProBNP odds ratios of 2.89 (95% confidence interval [CI]: 1.04–8.05) and 5.43 (95% CI: 1.21–24.44) and ST2 odds ratios of 3.96 (95% CI: 1.60–9.82) and 3.21 (95% CI: 1.17–8.80), respectively. The model receiver operating characteristic score of the base prediction model (0.80 [95% CI: 0.72–0.89]) varied significantly from the new multi‐marker model (0.85 [95% CI: 0.79–0.91]). Compared with the Northern New England (NNE) model alone, the full prediction model with biomarkers NT‐proBNP and ST2 shows significant improvement in model classification of in‐hospital mortality.ConclusionsThis study demonstrates a significant improvement of preoperative prediction of in‐hospital mortality in patients undergoing coronary artery bypass graft and suggests that biomarkers can be used to identify patients at higher risk.

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Aminoterminal B-type Pro–Natriuretic Peptide as a Marker of Recovery After High-risk Coronary Artery Bypass Grafting in Patients With Ischemic Heart Disease and Severe Impaired Left Ventricular Function

Cited by 8 publications

References 31 publications

Atorvastatin Therapy Is Associated with Reduced Levels of N‐terminal Prohormone Brain Natriuretic Peptide and Improved Cardiac Function in Patients with Heart Failure

Atorvastatin Therapy Is Associated with Reduced Levels of N‐terminal Prohormone Brain Natriuretic Peptide and Improved Cardiac Function in Patients with Heart Failure

N-Terminal ProBNP Levels Can Predict Cardiac Failure After Cardiac Surgery

Predictive Ability of Novel Cardiac Biomarkers ST2, Galectin‐3, and NT‐ProBNP Before Cardiac Surgery

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