O peptídeo natriurético do tipo B é preditor de eventos em pós-operatório de cirurgia ortopédica

Villacorta, Humberto; Castro, Isabela Simões de; Godinho, Marise; Mattos, Camila Bedeschi Rego De; Visconti, Rogério dos Reis; Saud, Maurício; Novais, Mônica; Murad, Cláudia; Nogueira, Fernanda

doi:10.1590/s0066-782x2010005000131

Cited by 16 publications

(12 citation statements)

References 15 publications

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“…N-terminal pro-brain natriuretic peptide (NT-pro-BNP), an inactive by-product resulting from the synthesis of BNP, is another member of the natriuretic peptide family [21]. Measurement of either plasma BNP or NT-pro-BNP levels is being increasingly used in the perioperative setting [9,12,14]. Yeh and colleagues investigated patients undergoing non-cardiac surgery and were the first to describe the capacity of NT-pro-BNP to predict the composite end-point of postoperative cardiac complications [24].…”

Section: Discussionmentioning

confidence: 99%

“…Their patient population fell into ASA class III or IV categories, and 49% of which experienced a perioperative adverse cardiac event. Villacorta and co-workers investigated preoperative BNP in patients undergoing orthopedic elective surgery where 8% of patients experienced a cardiac event [14]. They similarly found ASA classification to be a poor predictor of cardiac events.…”

Section: Discussionmentioning

confidence: 99%

“…Measurement of plasma levels of BNP or its N-terminal fragment (NT-pro-BNP) is being increasingly used in the perioperative setting [12]. Recently, a number of studies have examined the hypothesis that elevated preoperative plasma concentrations of natriuretic peptides can be used to identify patients at risk of adverse cardiac events [13,14]. …”

Section: Introductionmentioning

confidence: 99%

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Prediction of early postoperative major cardiac events after elective orthopedic surgery: the role of B-type natriuretic peptide, the revised cardiac risk index, and ASA class

et al. 2014

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BackgroundThe aim of this study was to evaluate pre- and post-operative brain natriuretic peptide (BNP) levels and compare the power of this test in predicting in-hospital major adverse cardiac events (MACE: atrial fibrillation, flutter, acute heart failure or non-fatal/fatal myocardial infarction) in patients undergoing elective prosthesis orthopedic surgery to that of the Revised Cardiac Risk Index (RCRI) and American Society of Anesthesiology (ASA) class, the most useful scores identified to date.MethodsThe study was an observational study of consecutive patients undergoing elective prosthesis orthopedic surgery. Surgical risk was established using RCRI score and ASA class criteria. Venous blood was sampled before surgery and on postoperative day 1 for the measurement of BNP. The intraoperative data collected included details of the surgery and anesthesia and any MACE experienced up until hospital discharge.ResultsMACE occurred in 14 of the 227 patients treated (6.2%). Age was statistical associated with MACE (p < 0.004). Preoperative BNP levels were higher (p < 0.0007) in patients who experienced MACE than in event-free patients (median values: 92 and 35 pg/mL, respectively). Postoperative BNP levels were also greater (p < 0.0001) in patients sustaining MACE than in event-free patients (median values: 165 and 45 pg/mL, respectively). ROC curve analysis demonstrated that for a cut-off point ≥ 39 pg/mL, the area under the curve for preoperative BNP was equal to 0.77, while a postoperative BNP cut-off point ≥ 69 pg/mL gave an AUC of 0.82.ConclusionsBoth pre- and post-operative BNP concentrations are predictors of MACE in patients undergoing elective prosthesis orthopedic surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prediction of early postoperative major cardiac events after elective orthopedic surgery: the role of B-type natriuretic peptide, the revised cardiac risk index, and ASA class

et al. 2014

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“…Brain natriuretic peptide (BNP) and N-terminal (NT) pro-BNP are other commonly investigated plasma biomarkers associated with the development of POAF. [21][22][23][24][25][26][27] A review in non-cardiac thoracic surgical patients reported that preoperative elevated BNP and NT-pro-BNP were predictive of POAF after both esophagectomy and major lung recessions, but not after minor non-cardiac thoracic surgery. 26 Likewise, several studies have found that elevated preoperative BNP predicted cardiac events including POAF in elective and emergency orthopedic surgery.…”

Section: Clinical Risk-factors and Prediction Modelsmentioning

confidence: 99%

“…26 Likewise, several studies have found that elevated preoperative BNP predicted cardiac events including POAF in elective and emergency orthopedic surgery. 21,22,28 Concerning cardiac surgery, a systematic review and meta-analysis found a moderate association between preoperative BNP and development of POAF. 23 More recent prospective and retrospective studies of cardiac surgical populations have confirmed a positive association between elevated preoperative BNP and NT pro-BNP, and POAF.…”

Section: Clinical Risk-factors and Prediction Modelsmentioning

confidence: 99%

<p>Predictors of Postoperative Atrial Fibrillation After Abdominal Surgery and Insights from Other Surgery Types</p>

Madsen¹,

Jørgensen²,

Leerhøy³

et al. 2020

RRCC

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Postoperative atrial fibrillation (POAF) in relation to abdominal surgery can cause clinical deterioration, prolonged hospitalization, admittance to intensive care units, stroke and increased mortality. The current review focus on patients developing POAF in relation to abdominal surgery and aims to present the current knowledge on predictors of this condition. Furthermore, predictors identified in other surgical populations that may be transferable and guide future research within the field of abdominal surgery will be presented. A systematic literature search of patients undergoing abdominal surgery and developing POAF was performed on PubMed and Embase. All types of study interventions, comparators and designs were included. All studies included reported POAF as primary or secondary outcome. All peer-reviewed English full-text manuscripts regardless of publication date were included. We included five studies out of the 149 unique records identified. Age, congestive heart failure, hypertension, vascular disease and surgical approach are risk factors associated with the development of POAF. Furthermore, inflammation biomarkers, dobutamine stress echocardiography and cardiac single-photon emission computed tomography can predict POAF. Insights from other surgical cohorts reveal that other biomarkers (ie, brain natriuretic peptide (BNP) and N-terminal pro-BNP), electrocardiography and echocardiography can be used to predict POAF and may be applied in future research projects within the field of abdominal surgery. In conclusion, very scarce evidence is currently available in predicting POAF after abdominal surgery. However, predicting POAF seems possible and feasible, why the authors encourage readers to initiate new research to close the current knowledge gap and improve clinical management.

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Preoperative Cardiac Risk Assessment for Noncardiac Surgery in Patients with Heart Failure

Upshaw

Kiernan

2013

Curr Heart Fail Rep

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The aging population and an epidemic of heart failure have led to an increasing volume of noncardiac surgical procedures being performed in patients with heart failure. Knowledge pertaining to perioperative risk stratification and management among this diverse and complex cohort of patients has therefore become increasingly important. Most available data regarding the management of patients with heart disease undergoing noncardiac surgery is specific to patients with ischemic heart disease, and focuses on the prevention of ischemia and its subsequent complications. This review instead specifically explores the available data regarding the epidemiology and outcomes of the surgical patient with heart failure, with a focus on risk stratification and perioperative management.

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O peptídeo natriurético do tipo B é preditor de eventos em pós-operatório de cirurgia ortopédica

Cited by 16 publications

References 15 publications

Prediction of early postoperative major cardiac events after elective orthopedic surgery: the role of B-type natriuretic peptide, the revised cardiac risk index, and ASA class

Prediction of early postoperative major cardiac events after elective orthopedic surgery: the role of B-type natriuretic peptide, the revised cardiac risk index, and ASA class

<p>Predictors of Postoperative Atrial Fibrillation After Abdominal Surgery and Insights from Other Surgery Types</p>

Preoperative Cardiac Risk Assessment for Noncardiac Surgery in Patients with Heart Failure

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