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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
N-terminal pro-B-type natriuretic peptide concentrations and long-term outcome after cardiac surgery: A prospective cohort study
British Journal of Anaesthesia, Volume 110, No. 2, Year 2013
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Description
BackgroundN-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations predict cardiovascular outcome in many settings. There are very few data assessing the utility of NT-proBNP concentrations in the prediction of long-term outcome after cardiac surgery. We assessed the ability of NT-proBNP to predict 3 yr mortality compared with validated clinical risk prediction tools.MethodsA secondary analysis of a prospectively recruited patient cohort of 1010 patients undergoing cardiac surgery. Baseline clinical details were obtained including EuroSCORE. Multi-variable modelling, area under the receiver operating characteristic curves (AUCs), and net reclassification improvement were utilized.ResultsNT-proBNP was a univariable predictor of 3 yr mortality but was no longer a significant predictor in a multivariable model (hazard ratio 1.00 per 250 ng litre-1, 95% confidence interval 0.98-1.02, P=0.80). The relative and additive predictive values of the preoperative EuroSCORE (both additive and logistic versions) and NT-proBNP concentrations were compared. All were predictive of 3 yr mortality (P<0.001) with almost identical AUCs (0.71 for EuroSCORE, 0.70 for NT-proBNP). When either the EuroSCORE or NT-proBNP concentrations are known, the addition of the other does not improve the ability to predict 3 yr mortality.ConclusionsPreoperative NT-proBNP concentrations and the EuroSCORE have equivalent, and moderate, predictive accuracy for mortality 3 yr after cardiac surgery. EuroSCORE uses clinical data but is not routinely used for individual clinical risk prediction. NT-proBNP measurement would incur additional costs but can be measured quickly and objectively. With such similar predictive accuracy, factors such as the ease of calculation and cost will likely determine their use in clinical practice. © 2012 © The Author [2012]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved.
Authors & Co-Authors
Cuthbertson, Brian H.
Canada, Toronto
Sunnybrook Health Sciences Centre
Croal, Bernard Lewis
United Kingdom, Aberdeen
Aberdeen Royal Infirmary
Harrild, Kirsten A.
United Kingdom, Aberdeen
University of Aberdeen
Kengne, Andre-Pascal Pascal
Australia, Sydney
Royal Prince Alfred Hospital
Hillis, Graham Scott
Australia, Sydney
Royal Prince Alfred Hospital
Statistics
Citations: 17
Authors: 5
Affiliations: 4
Identifiers
Doi:
10.1093/bja/aes379
ISSN:
00070912
Research Areas
Environmental
Health System And Policy
Noncommunicable Diseases
Study Design
Cohort Study
Study Approach
Quantitative