Perioperative Serum Brain Natriuretic Peptide and Cardiac Troponin in Elective Intracranial Surgery

Ruggieri, F; Gemma, Marco; Calvi, Maria Rosa; Nicelli, Elisa; Agarossi, Andrea; Beretta, Luigi

doi:10.1007/s12028-012-9684-2

Cited by 10 publications

(8 citation statements)

References 32 publications

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“…Studies in traumatic brain injury patients found that more severe brain damage was associated with greater elevation of NT-proBNP concentrations in serum and in cerebrospinal fluid 7 , 27 . In a similar vein, greater mass effect and perifocal edema is associated with higher serum NT-proBNP concentrations in primary and metastatic brain tumor patients 13 , 14 . Necrosis and peri-tumoral edema are characteristics of rapidly growing aggressive brain tumors, and therefore can contribute to the observed increase of serum NT-proBNP concentrations.…”

Section: Discussionmentioning

confidence: 79%

“…Tumor grade, patient age and functional status, and extent of surgical tumor resection are the most important prognostic indicators for malignant brain tumors 12 . Two previous studies in primary and metastatic brain tumor patients reported that greater NT-proBNP concentration was associated with greater mass effect and extent of perifocal brain edema 13 , 14 . However, the association of NT-proBNP concentration with health status and prognosis of brain tumor patients was not reported.…”

Section: Introductionmentioning

confidence: 95%

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Preoperative N-terminal pro-B-type natriuretic peptide concertation and prognosis of brain tumor patients: a 5-year follow up study

Bunevičius

Deltuva

Laws

et al. 2017

Sci Rep

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Increased N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration predicts poor prognosis of non-CNS cancer patients. We evaluated the association of NT-proBNP concentration with disease severity, discharge outcomes and prognosis of patients undergoing craniotomy for brain tumor. From January, 2010 until September, 2011 two-hundred and forty-five patients (age 55.05 ± 14.62 years) admitted for brain tumor surgery were evaluated for NT-proBNP serum concentration. Outcome at hospital discharge was evaluated with the Glasgow Outcome Scale (GOS). Most common diagnoses were meningioma (37%) and high-grade glioma (20%). Greater NT-proBNP concentration was associated with lower Barthel index (rho = −0.305, p = 0.001) and Mini Mental State Examination scores (rho = −0.314, p = 0.001) and with greater Hospital Anxiety and Depression scale Depression score (rho = 0.240, p = 0.026). Greater admission NT-proBNP concentration was associated with lower discharge GOS score after adjusting for patient age, gender and histological brain tumor diagnosis (β = −0.253, p < 0.001). Greater NT-proBNP concentration was also associated with greater 5-year mortality risk (HR = 1.845; 95%CI [1.166–2.920], p = 0.009) controlling for patient age, gender, history of cardiovascular disease, histological diagnosis and adjuvant therapy. In sum, greater pre-operative NT-proBNP concentration is associated with worse health status, unfavorable discharge outcome and shorter survival of brain tumor patients.

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Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 95%

Preoperative N-terminal pro-B-type natriuretic peptide concertation and prognosis of brain tumor patients: a 5-year follow up study

Bunevičius

Deltuva

Laws

et al. 2017

Sci Rep

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“…In line with previous findings, we found that cardiovascular comorbidity and older age were related to greater NT-proBNP concentrations [25,26], suggesting that NT-proBNP can be a valuable biomarker of underlying cardiovascular function impairment of BT patients. However, Ruggieri et al [18] in a sample of 108 BT patients found no association between increase in NT-proBNP and cardiac dysfunction; levels of NT-proBNP were directly associated with cerebral damage. Clinical importance of subclinical impairment of cardiac function as well as its clinical biomarkers warrants further research in BT patient population despite our preliminary negative results.…”

Section: Discussionmentioning

confidence: 92%

“…Inflammatory response is important for development, progression, and prognosis of malignant [15,16] and benign [17,18] BTs. Greater circulating hsCRP concentration was linked to shorter survival of glioma [19] and meningioma [20] patients.…”

Section: Introductionmentioning

confidence: 99%

Clinical and Biological Correlates of Preoperative Cognitive Functioning of Glioma and Meningioma Patients

Pranckevičienė

Deltuva

Tamašauskas

et al. 2020

BioMed Research International

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Objectives. This study aimed to investigate the association of high-sensitivity C-reactive protein (hsCRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) serum concentrations with cognitive functions of glioma and meningioma patients. Methods. 177 brain tumor patients awaiting for brain tumor surgery participated in the study. Patients were assessed preoperatively, using neuropsychological tests for verbal memory, psychomotor speed, mental flexibility, and verbal fluency. The functional status of patients was evaluated using the Karnofsky Performance Index. Blood samples were drawn for evaluation of serum hsCRP and NT-proBNP concentrations upon hospital admission. Results. The highest NT-proBNP concentration was observed in meningioma patients. Glioma and meningioma patients did not differ in hsCRB concentration. Patients in the highest hsCRP tertile were older and more frequently reported cardiovascular comorbidity. Patients in the highest NT-proBNP tertile were older, more frequently with cardiovascular comorbidity, females, and diagnosed with a meningioma. hsCRP was significantly related to slower psychomotor speed in high-grade glioma patients (rho=0.30, p<0.05). In meningioma sample, NT-proBNP correlated with decreased psychomotor speed (rho=0.38, p<0.01), mental flexibility (rho=0.33, p<0.01), worse cumulative learning (rho=−0.27, p<0.05), and delayed recall (rho=0.30, p<0.01). However, the relationship between the NT-proBNP and cognitive functions became nonsignificant when demographic and clinical covariates were included into analysis. Higher hsCRP concentration remained significantly related to slower psychomotor speed (p=0.02) and worse mental flexibility (p=0.05) in glioma patients, independently from demographic and clinical covariates. Preoperative cognitive functioning was also predicted by older age, gender, side and location of the tumor, and tumor malignancy, and general functional status of a patient. Conclusions. NT-proBNP was not associated with memory, language, and attention/executive cognitive domains of glioma and meningioma patients. Increased hsCRP was related to slower psychomotor speed and worse mental flexibility in glioma patients, indicating that inflammation processes are important for cognitive functioning in glial tumors.

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“…Ruggieri et al [20] analyzed N-terminal pro-brain natriuretic peptide and the prognostic value of serum cardiac troponin T in patients with no history of cardiac anomalies before and after elective surgery for intracranial tumor resection. Serum troponin T and N-terminal pro-brain natriuretic peptide levels were measured in 108 patients.…”

Section: Discussionmentioning

confidence: 99%

High-Sensitivity Troponin T Predicts Perioperative Adverse Events in Patients Undergoing Neurosurgical Procedures

Acarbaş¹

2019

Int J Med Biochem

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High-sensitivity troponin T predicts perioperative adverse events in patients undergoing neurosurgical procedures T he early recognition of predictors of adverse outcomes in patients undergoing surgery is important for timely risk strat-ification and management [1]. Clinical risk stratification tools and preoperative laboratory tests have frequently been used as a component of the preoperative workup for patients undergoing various surgical procedures [1]. Several studies have reported that patient factors, comorbidities, and surgical characteristics are associated with a higher incidence of complications in neurosurgery [2, 3]. However, only a few studies have examined the association between preoperative biomarkers and pe-rioperative complications following neurosurgical procedures. Troponins are proteins that regulate the calcium-induced interaction between myosin and actin that results in muscle contraction [4]. Troponin I and troponin T are the most widely used and are the most specific biomarkers for myocyte injury. Elevated troponin levels are a predictor of major adverse events in multiple settings [5, 6]. Multiple studies have demonstrated that preoperative troponin I and T are valuable predictors of worse outcomes not only after cardiac or vascular surgery but also after noncardiac surgeries [7-10]. Although the predictive value of cardiac biomarkers, such as troponins and natriuretic peptides, has been evaluated in various noncardiac surgical Objectives: Previous studies have shown that troponin is a valuable predictor of perioperative complications after non-cardiac surgery. However, the relationship of the preoperative troponin level with perioperative adverse events has not been well described in patients undergoing neurosurgical procedures. The aim of this study was to evaluate the impact of the preoperative high-sensitivity cardiac troponin T (hs-cTnT) level on the outcome of patients who underwent neurosurgery. Methods: The records of 2519 patients who were over 18 years of age and underwent elective neurosurgery between December 2014 and December 2018 were retrospectively evaluated. Patient medical and demographic data and the results of routine preoperative laboratory tests, including the hs-cTnT level, were collected to assess a potential association between these factors and perioperative adverse events. Results: Perioperative adverse events occurred in 251 (10.0%) patients. Older patients and those with more comorbid conditions tended to have a higher rate of perioperative adverse events. The preoperative hs-cTnT level was significantly higher in the individuals who experienced a complicated in-hospital course than in those who did not (21.6±8.2 ng/L vs 6.3±3.1 ng/L; p<0.001). Multivariate analysis indicated that age (odds ratio [OR]: 2.33, 95% confidence interval [CI]: 1.16-4.35; p<0.01), the presence of diabetes (OR: 3.13; 95% CI: 1.15-6.32; p=0.004), and a preoperative hs-cTnT level of >18.3 ng/L (OR: 4.51, 95% CI: 2.34-7.82; p<0.001) were significant and independent predictors of periope...

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Perioperative Serum Brain Natriuretic Peptide and Cardiac Troponin in Elective Intracranial Surgery

Abstract: An intracranial mass effect is associated with higher NT-proBNP serum levels in patients with a brain neoplasm. Following elective intracranial surgery for brain tumor resection NT-proBNP values increase.

Cited by 10 publications

References 32 publications

Preoperative N-terminal pro-B-type natriuretic peptide concertation and prognosis of brain tumor patients: a 5-year follow up study

Preoperative N-terminal pro-B-type natriuretic peptide concertation and prognosis of brain tumor patients: a 5-year follow up study

Clinical and Biological Correlates of Preoperative Cognitive Functioning of Glioma and Meningioma Patients

High-Sensitivity Troponin T Predicts Perioperative Adverse Events in Patients Undergoing Neurosurgical Procedures

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