Prognostic value of N-terminal pro-form B-type natriuretic peptide (NT-proBNP) in patients with congenital heart disease undergoing cardiac surgery: a systematic review and meta-analysis of cohort studies

Gong, Ziqiang; Xing, Dexiu; Wu, Rong; Zhang, Senmao; Ye, Changxiang; Chen, Yan; Liu, Xiaoling; Wang, Tingting

doi:10.21037/cdt-22-155

Cited by 5 publications

(4 citation statements)

References 52 publications

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“…Incidence of an acute kidney injury (AKI) in patients undergoing heart valve surgery is a fairly common complication observed in the early postoperative period, occurring with a frequency of about 3 to 34% [5,15,16]. Despite constant progress in intensive care, nephrology and dialysis, mortality in acute kidney injury remains high-in the presented study, out of 50 patients with postoperative AKI requiring renal replacement therapy, inhospital death occurred in 38 patients.…”

Section: Discussionmentioning

confidence: 79%

“…So far, the available literature lacks clear information on the predictive ability of the preoperative Nt-proBNP level in predicting the occurrence of postoperative AKI requiring renal replacement therapy in patients undergoing heart valve surgery. It has been shown that an increased level of Nt-proBNP is an independent predictor of the occurrence of postoperative AKI in the general group of adult patients treated with cardiac surgery as well as in the pediatric group; otherwise, it has been demonstrated that elevated Nt-proBNP values are associated with a prolonged stay in an intensive care unit after cardiac surgery for congenital heart defects [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of the N-Terminal of the Prohormone Brain Natriuretic Peptide in Predicting Acute Kidney Injury Requiring Renal Replacement Therapy in Patients Undergoing Heart Valve Surgery

Duchnowski,

Śmigielski

2023

Medicina

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Background and Objectives: By definition, acute kidney injury (AKI) is a clinical syndrome diagnosed when the increase in serum creatinine concentration is >0.3 mg/dL in 48 h or >1.5-fold in the last seven days or when diuresis < 0.5 mL/kg/h for a consecutive 6 h. AKI is one of the severe complications that may occur in the early postoperative period in patients undergoing heart valve surgery, significantly increasing the risk of death. Early implementation of renal replacement therapy increases the chances of improving treatment results in patients with postoperative AKI. The study assessed the predictive ability of selected preoperative and perioperative parameters for the occurrence of postoperative AKI requiring renal replacement therapy in the early postoperative period in a group of patients with severe valvular heart disease. Materials and Methods: A prospective study was conducted on a group of patients undergoing consecutive heart valve surgeries. The primary endpoint was postoperative AKI requiring renal replacement therapy. AKI was diagnosed with an increase in serum creatinine > 0.3 mg/dL in 48 h or >1.5-fold in the previous 7 days and/or a decrease in diuresis < 0.5 mL/kg/h for 6 h. The observation period was until the patient was discharged home or death occurred. Logistic regression analysis was used to assess which variables were predictive of primary endpoint, and odds ratios (OR) were calculated with a 95% confidence interval (CI). Multivariate analysis was based on the result of single factor logistic regression, i.e., to further steps, all statistically significant variables were taken into consideration. Results: A total of 607 patients were included in the study. The primary endpoint occurred in 50 patients. At multivariate analysis: NT-proBNP (OR 1.406; 95% CI 1.015–1.949; p = 0.04), CRP (OR 1.523; 95% CI 1.171–1.980; p = 0.001), EuroSCORE II (OR 1.090; 95% CI 1.014–1.172; p = 0.01), age (OR 1.037; 95% CI 1.001–1.075; p = 0.04) and if they stayed in the intensive care unit longer than 2 days (OR 9.077; 95% CI 2.026–40.663; p = 0.004) remained the independent predictors of the primary endpoint. The mean preoperative NT-proBNP level was 2063 pg/mL (±1751). Thirty-eight patients with AKI requiring renal replacement therapy died in intrahospital follow-up. Conclusions: The results of the presented study indicate that a high preoperative level of NT-proBNP and postoperative hemodynamic instability may be associated with a significant risk of a postoperative AKI requiring renal replacement therapy. The results of the study may also suggest that qualifying for heart valve surgery earlier may be associated with improved prognosis in this group of patients.

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Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Usefulness of the N-Terminal of the Prohormone Brain Natriuretic Peptide in Predicting Acute Kidney Injury Requiring Renal Replacement Therapy in Patients Undergoing Heart Valve Surgery

Duchnowski,

Śmigielski

2023

Medicina

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“…IGF-1 is a peptic hormone that has been connected to various cardiovascular diseases, where higher serum levels show to have cardioprotective effects (improves cardiomyopathy, modulates myocardial remodeling post-infarction…), while lower serum levels are associated with unfavorable cardiac outcome. 19 Only three patients (6.2%) had abnormal values in this study and, consequently, the number was underpowered to establish an association between the biomarker and morphological or hemodynamic changes. NT-proBNP has been identified as a marker of HF and its prognostic value in CHD is currently under investigation.…”

Section: Biomarkersmentioning

confidence: 87%

Biomarkers in transposition of the great arteries after arterial switch operation: A pilot trial with deep phenotyping

Conings,

Santens,

De Meester

et al. 2024

International Journal of Cardiology

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“…In previous studies, researchers have sought strongly to elaborate the postoperative prognostic value of NT-proBNP in pediatric CHD patients 18 . Most studies focused on early postoperative outcomes, and the results showed that NT-proBNP had significant predictive value for longer ICU stay and mechanical ventilation, inotropic support, and acute kidney injury 19 – 22 .…”

Section: Discussionmentioning

confidence: 99%

Predictive value of NT-proBNP and hs-TnT for outcomes after pediatric congenital cardiac surgery

Shen,

He,

Shao

et al. 2024

International Journal of Surgery

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Background: The available evidence regarding the predictive value of troponins and natriuretic peptides for early postoperative outcomes in pediatrics is limited, controversial, and based on small sample sizes. We aimed to investigate the association of N-terminal pro B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (hs-TnT) with the in-hospital adverse outcomes after congenital cardiac surgeries. Methods: A secondary analysis based on a prospective study of pediatric congenital heart disease (CHD) patients was conducted to investigate the association of NT-proBNP and hs-TnT tested within 6 hours postoperatively with in-hospital adverse events. A multivariate logistic regression analysis with a minimum P value approach was used to identify the optimal thresholds of NT-proBNP and hs-TnT for risk stratification. Results: NT-proBNP and hs-TnT are positively correlated with cardiopulmonary bypass time, mechanical ventilation duration, and pediatric intensive care unit stay. The predictive performance of NT-proBNP is excellent for adverse events in both patients younger than 1 year [area under the curve (AUC): 0.771, 0.693-0.850] and those older than 1 year (AUC: 0.839, 0.757-0.922). However, hs-TnT exhibited a satisfactory predictive value solely in patients aged over 1 year. (AUC: 0.784, 0.717-0.852). NT-proBNP levels of 2000 to 10000 ng/L [Odds Ratio (OR): 3.79, 1.47-9.76) and exceeding 10000 ng/L (OR: 12.21, 3.66-40.80) were associated with a higher risk of postoperative adverse events in patients younger than 1 year. Patients older than 1 year, with NT-proBNP higher than 500 ng/L (OR: 15.09, 6.05-37.66) or hs-TnT greater than 1200 ng/L (OR: 5.50, 1.47-20.59), had a higher incidence of postoperative adverse events. Conclusions: NT-proBNP and hs-TnT tested within postoperative 6 hours demonstrated significant predictive value for postoperative adverse events in CHD patients older than 1 year. However, among CHD patients younger than 1 year, only NT-proBNP exhibited commendable predictive performance for postoperative adverse events.

show abstract

Prognostic value of N-terminal pro-form B-type natriuretic peptide (NT-proBNP) in patients with congenital heart disease undergoing cardiac surgery: a systematic review and meta-analysis of cohort studies

Cited by 5 publications

References 52 publications

Usefulness of the N-Terminal of the Prohormone Brain Natriuretic Peptide in Predicting Acute Kidney Injury Requiring Renal Replacement Therapy in Patients Undergoing Heart Valve Surgery

Usefulness of the N-Terminal of the Prohormone Brain Natriuretic Peptide in Predicting Acute Kidney Injury Requiring Renal Replacement Therapy in Patients Undergoing Heart Valve Surgery

Biomarkers in transposition of the great arteries after arterial switch operation: A pilot trial with deep phenotyping

Predictive value of NT-proBNP and hs-TnT for outcomes after pediatric congenital cardiac surgery

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