Abstract | INTRODUCTION: METHODS: A detailed cardiac history, resting echocardiography, and hemoglobin and NT-proBNP levels were obtained in 666 patients before vascular surgery. Anemia was defined as serum hemoglobin <13 g/dL for men and <12 g/dL for women. Troponin T measurements and 12-lead electrocardiograms were performed on postoperative days 1, 3, 7, and 30 and whenever clinically indicated. The primary end point of the study was the composite of 30-day postoperative cardiovascular death, nonfatal myocardial infarction, and troponin T release. Receiver operating characteristic curve analysis was used to assess the optimal cutoff value of NT-proBNP for the prediction of the composite end point. Multivariable regression analysis was used to assess the additional value of NT-proBNP for the prediction of postoperative cardiac events in nonanemic and anemic patients. RESULTS:
Anemia was present in 206 patients (31%) before surgery. Hemoglobin level was inversely related with the NT-proBNP levels (beta coefficient = -2.242; P = 0.025). The optimal predictive cutoff value of NT-proBNP for predicting the composite cardiovascular outcome was 350 pg/mL. After adjustment for clinical cardiac risk factors, both anemia (odds ratio [OR] 1.53; 95% confidence interval [CI]: 1.07-2.99) and increased levels of NT-proBNP (OR 4.09; 95% CI: 2.19-7.64) remained independent predictors for postoperative cardiac events. However, increased levels of NT-proBNP were not predictive for the risk of adverse cardiac events in the subgroup of anemic patients (OR 2.16; 95% CI: 0.90-5.21). CONCLUSIONS:
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Authors | Dustin Goei, Willem-Jan Flu, Sanne E Hoeks, Wael Galal, Martin Dunkelgrun, Eric Boersma, Ruud Kuijper, Jan-Peter van Kuijk, Tamara A Winkel, Olaf Schouten, Jeroen J Bax, Don Poldermans |
Journal | Anesthesia and analgesia
(Anesth Analg)
Vol. 109
Issue 5
Pg. 1403-8
(Nov 2009)
ISSN: 1526-7598 [Electronic] United States |
PMID | 19843778
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Biomarkers
- Hemoglobins
- Peptide Fragments
- Troponin T
- pro-brain natriuretic peptide (1-76)
- Natriuretic Peptide, Brain
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Topics |
- Aged
- Anemia
(blood, complications)
- Biomarkers
(blood)
- Electrocardiography
- Female
- Heart Diseases
(blood, etiology, mortality)
- Hemoglobins
(metabolism)
- Humans
- Linear Models
- Male
- Middle Aged
- Natriuretic Peptide, Brain
(blood)
- Odds Ratio
- Peptide Fragments
(blood)
- Predictive Value of Tests
- ROC Curve
- Retrospective Studies
- Risk Assessment
- Risk Factors
- Time Factors
- Treatment Outcome
- Troponin T
(blood)
- Vascular Surgical Procedures
(adverse effects, mortality)
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