Abstract 4351: Preoperative Serum Nt-pro Brain Type Natriuretic Peptide Predicts Perioperative Outcome and Midterm Survival Rates of CABG Patients
Background: N-terminal fragment of pro brain type natriuretic peptide (BNP) is an established biomarker for cardiac failure. We aimed to determine the influence of preoperative serum BNP on perioperative outcome and mid-term survival in coronary artery bypass grafting (CABG) patients.
Patients and Methods: In 819 isolated CABG patients preoperative serum BNP levels were mesured. BNP was correlated with various postoperative outcome parameters and survival rate after a median follow-up time of 18 (0.5– 44) months. Risk factors of mortality were identified using Chi-square, Mann-Whitney test and Cox-Regression.
esults: BNP levels >430ng/ml and 502ng/ml predicted hospital and overall mortality (p<0.05), the incidences of which, were 1.6% and 4% respectively. Kaplan-Meier analysis revealed decreased survival rates in patients with BNP >502ng/ml (p=0.001, Table 1). Age, preoperative serum creatinine, diabetes, chronic obstructive pulmonary disease, ejection fraction and BNP levels>502 have been isolated as dependent risk factors for overall mortality. Multivariate Cox regression analysis identified BNP as an independent risk factor for mortality OR=3.079(CI=1.149 – 8.247), p=0.025. Preoperative BNP levels >502 ng/ml were associated with increased ventilation time (p=0.005), longer ICU stay (p=0.001), higher incidence of postoperative hemofiltration (p=0.001), use of intraaortic balloon pump (p<0.001), and postoperative atrial fibrillation (p=0.031)
Conclusions: Preoperative BNP levels >502ng/ml predict mid-term mortality after isolated CABG and are associated with significantly higher hospital mortality and perioperative complications.