Release of Brain Natriuretic-Related Peptides (BNP, NT-proBNP) and Cardiac Troponins (cTnT, cTnI) in On-pump and Off-pump Coronary Artery Bypass Surgery

Abstract

The data were analyzed first for off-pump versus the CPB procedures and second for warm versus cold cardioplegia. The plasma troponin releases appeared to be significantly higher in the CPB groups in comparison to the beating heart group (P < 0.001 and P < 0.002 for cTnI and cTnT peak values, respectively). The peak of the B-type natriuretic peptide release appeared to be more delayed in the groups undergoing CPB than in the beating heart group (day 6 versus days 2 and 4 for NT-proBNP and BNP, respectively). Taken together, our results indicated that the new generation of cTnT assays seemed to be more sensitive than the cTnI assays for the diagnosis of myocardium injury. A lower increase in the cTnT values in the warm cardioplegic group indicated less damage of the myocardium than with cold cardioplegia. Our data also confirm better preservation of the myocardium with off-pump cardiac surgery than with CPB.

The Relationship between the Changes of Blood NT-proBNP Levels and Postoperative Atrial Fibrillation Occurance in Coronary Artery By-Pass Grafting Surgery Patients

“…This clinical situation may continued during weeks [28] [30]. In our study, postoperative NT-proBNP levels increased gradually in both goups.…”

“…In a previous study included patients with and without left ventricular dysfunction in CABG patients has been reported that no correlation has been detected between blood proBNP levels and NOAF. This study demonstrated that there was no statistical significancy NOAF after surgery when compared to two groups' BNP level changes in post surgery 24t h. However, the same authors stated that 48th h post surgery, there was a significant increment in NOAF in theirs groups who have had high BNP levels [30].…”

The Role of BNP and CRP in Predicting the Development of Atrial Fibrillation in Patients Undergoing Isolated Coronary Artery Bypass Surgery

“…In contrast Mahar and coworkers showed in their series that peak BNP values appear to be no different between those undergoing CABG surgery with or without cardiopulmonary bypass [23], while Guerin et al reported that the time to peak BNP value appears to be slightly slower for those undergoing cardiopulmonary bypass [24]. These discrepancies to other researchers' results may be attributed on the one hand to the relative small sample size of 18% in our cohort undergoing “off-pump” surgery, and on the other hand on the timing of postoperative BNP measurement (early on 1st POD) “missing” in that way some of the peak values.…”

Preoperative plasma BNP concentrations: do they improve our care of high-risk non-cardiac surgical patients?

“…BNP has shown utility as a diagnostic tool in the evaluation of acute dyspnoea. A blood value ,100 pg ml 21 was thought to make a diagnosis of congestive cardiac failure unlikely, whereas a value of .500 pg ml 21 made it highly likely. 6 BNP has been advocated as a sensitive marker of ventricular dysfunction, with the concentration of BNP varying according to the grade of cardiac failure by the New York Heart Association (NYHA) classification; progressively increasing from Grade I to Grade IV of this scale.…”

“…Furthermore, the utility of BNP as a biomarker in other settings has been assessed, including screening for preclinical disease in asymptomatic individuals. In elderly subjects (age .80 yr) with no history of cardiac disease, it has been shown that for each increase in the plasma BNP concentration of 50 pg ml 21 , there is an associated increase in cardiac events of 1.6-fold and total mortality of 1.4-fold over a 2 yr follow-up period. 7 When the Framingham Offspring Study Database was interrogated, BNP values .20 pg ml 21 were associated with an increase of more than 60% in the long-term risk of death.…”