Preoperative Brain Natriuretic Peptide (BNP) Is a Better Predictor of Adverse Cardiac Events Compared to Preoperative Scoring System in Patients Who Underwent Abdominal Surgery

Mercantini, Paolo; Somma, Salvatore Di; Magrini, L.; Nava, Andrea; Scarinci, Andrea; Torre, Marco La; Ferri, Mario; Ferri, Enrico; Petrucciani, Niccolò; Ziparo, Vincenzo

doi:10.1007/s00268-011-1354-6

Cited by 21 publications

(26 citation statements)

References 44 publications

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“…In total, 24 of the 28 studies 29,[34][35][36][37][38][40][41][42][43][46][47][48][49][50][51][52][53][55][56][57][58][59][60] were prospective observational cohort studies. Of the remaining four studies: …”

Section: Methodsmentioning

confidence: 99%

“…Of the remaining studies, three reported exclusively on patients undergoing emergency surgery, 38,45,48 and one documented both elective and emergency surgeries that were classified as being high risk. 46 Certain studies investigated outcomes in a specific surgical discipline, including thoracic surgery (4), 36,50,51,54 vascular (7), 29,40,42,44,55,57,59 orthopaedic (5), 45,[47][48][49]60 major abdominal (1), 56 oesophagectomy (1), 41 while the rest documented outcomes following a variety of surgeries performed (10), 34,35,[37][38][39]43,46,52,53,58 including a mix of general, head and neck, gynaecological, orthopaedic, vascular, urological, neurosurgery and thoracic surgery.…”

Section: Included Studiesmentioning

confidence: 99%

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Preoperative B-type natriuretic peptides in patients undergoing noncardiac surgery: a cumulative meta-analysis

Ryan

Rajah

Simmers

et al. 2015

Southern African Journal of Anaesthesia and Analgesia

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Background: A plethora of studies have shown elevated preoperative natriuretic peptide measurements to predict postoperative mortality and adverse cardiac events. Objectives: The current study aimed to demonstrate this overwhelming association and to show that further studies of this nature are unwarranted. Methods: A cumulative meta-analysis of 28 studies was conducted where the primary outcomes of mortality and adverse cardiac events were associated with elevated preoperative natriuretic peptides. Results:Cumulative meta-analysis demonstrated an odds ratio trending to a constant of 5.66, with a marked narrowing in the 95% confidence interval. Conclusions:Further studies aiming only to demonstrate an association between a preoperative natriuretic peptide threshold and the risk of postoperative adverse cardiac events are not justified. Future investigation should focus on the clinical implications of these data and the application of these findings with regard to further investigation, optimisation and appropriate adaptation of perioperative management.

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Section: Methodsmentioning

confidence: 99%

Section: Included Studiesmentioning

confidence: 99%

Preoperative B-type natriuretic peptides in patients undergoing noncardiac surgery: a cumulative meta-analysis

Ryan

Rajah

Simmers

et al. 2015

Southern African Journal of Anaesthesia and Analgesia

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“…Most of the studies evaluating BNPs had levels drawn within 2 weeks prior to the day of surgery, typically at one time-point, however recent studies have incorporated perioperative BNP levels (levels drawn preoperatively and up to 5 days following surgery) [36,38,43,[45][46]. Preoperative BNPs have been found to be an independent predictor or associated with increased postoperative cardiac events [35][36][37][38][39][40][41][42][43][44]47,142] or mortality [24,41,[46][47] in noncardiac surgery, including cardiac morbidity at 30 days following discharge from hospitalization [38].…”

Section: Brain Natriuretic Peptides As a Marker Of Cardiovascular Rismentioning

confidence: 99%

“…Studies measuring BNPs in patients undergoing noncardiac surgery have investigated the role in the perioperative period for risk prediction or associations with adverse postoperative myocardial events [35][36][37][38][39][40][41][42][43][44], prolonged hospital stay [45] and mortality [24,[46][47] (see Table 4). Most of the studies evaluating BNPs had levels drawn within 2 weeks prior to the day of surgery, typically at one time-point, however recent studies have incorporated perioperative BNP levels (levels drawn preoperatively and up to 5 days following surgery) [36,38,43,[45][46].…”

Section: Brain Natriuretic Peptides As a Marker Of Cardiovascular Rismentioning

confidence: 99%

Sleep Apnea in Total Joint Arthroplasty Patients and the Role for Cardiac Biomarkers for Risk Stratification: an Exploration of Feasibility

et al. 2016

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Obstructive sleep apnea (OSA) is highly prevalent in patients undergoing total joint arthroplasty (TJA) and is a major risk factor for postoperative cardiovascular complications and death. Recognizing this, the American Society of Anesthesiologists urges clinicians to implement special considerations in the perioperative care of OSA patients. However, as the volume of patients presenting for TJA increases, resources to implement these recommendations are limited. This necessitates mechanisms to efficiently risk stratify patients having OSA who may be susceptible to post-TJA cardiovascular complications. We explore the role of perioperative measurement of cardiac troponins (cTns) and brain natriuretic peptides (BNPs) in helping determine which OSA patients are at increased risk for post-TJA cardiovascular-related morbidity.

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“…Recent advancements in the diagnosis of CRC and the worldwide diffusion of screening programs have led to an increase in the detection of pathologically T1 (pT1) CRCs [4,5]. The increasing of early stage CRCs allowed, in the last decades, the development of less invasive treatment including local resections, such as endoscopic mucosal/submucosal dissection (ESD) and transanal endoscopic microsurgery (TEM) in selected rectal cancer patients [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Standard versus Limited Colon Resection for High Risk T1 Colon Cancer. A Matched Case-Control Study

Torre¹,

Nigri²,

Mazzuca³

et al. 2014

JGLD

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Background & Aims: National Comprehensive Cancer Network (NCCN) recommends a colectomy in presence of high risk T1 colon polyps considering the risk of incomplete lymph node dissection or presence of residual disease. We evaluated the outcomes of segmental versus standard colon resection for high risk T1 colon cancers, in order to demonstrate if segmental colectomy (SegCR) allows same short-term and oncological results compared to standard radical colectomy (StaCR).Methods. A matched case-control study on patients who had undergone segmental versus standard colon resection was performed. One-hundred and two patients with high risk T1 colon cancer after endoscopic polypectomy, divided in 2 homogeneous groups of 51 cases, were analyzed, and intra-operative, post-operative and oncological data were compared.Results. Segmental colectomy allowed less operative time and intra-operative blood loss compared to StaCR (p < 0.001). Hospital stay after SegCR was shorter compared to StaCR (p < 0.001). No differences were found in terms of overall morbidity and mortality rates. Five-year actuarial overall, disease-free and disease-specific survival after StaCR were similar to SegCR (87%, 96% and 95% vs. 88%, 97% and 94%, respectively, p = 0.51, p=0.33, p=0.78).Conclusions. According to our findings, SegCR can be a valid alternative to StaCR for high risk T1 colon polyps. Segmental colectomy allows better peri-operative outcomes compared to StaCR ensuring the same oncological long-term outcomes.

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Preoperative Brain Natriuretic Peptide (BNP) Is a Better Predictor of Adverse Cardiac Events Compared to Preoperative Scoring System in Patients Who Underwent Abdominal Surgery

Abstract: We have demonstrated that elevated preoperative BNP levels are independent predictors of adverse cardiac events in a cohort of patients undergoing major abdominal surgery in a general surgery department, and this is the first study about this specific cohort of patients.

Cited by 21 publications

References 44 publications

Preoperative B-type natriuretic peptides in patients undergoing noncardiac surgery: a cumulative meta-analysis

Preoperative B-type natriuretic peptides in patients undergoing noncardiac surgery: a cumulative meta-analysis

Sleep Apnea in Total Joint Arthroplasty Patients and the Role for Cardiac Biomarkers for Risk Stratification: an Exploration of Feasibility

Standard versus Limited Colon Resection for High Risk T1 Colon Cancer. A Matched Case-Control Study

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