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Cardiac risk stratification in elective non-cardiac surgery: role of NT-proBNP.

AIM
The aim of the study was to investigate the utility of NT-proBNP measurement for the stratification of presurgical cardiac risk.


METHODS
Cardiac risk before elective non-cardiac surgery was evaluated in 82 consecutive patients. From each patient a venous blood sample was drawn to determinate NT-proBNP levels. Patients were followed up over three months in order to detect the occurrence of cardiac adverse events.


RESULTS
NT-proBNP was positively correlated (P<0.0001) with age, days of hospitalization (P=0.001) and ASA class (P=0.001). High surgical risk (P<0.0001), diabetes (P=0.004), dyslipidemia (P=0.006) and elevated levels of NT-proBNP (P<0.0001) were significantly correlated with events. Using a logistic regression analysis we found an independent association between pre-operative elevated NT-proBNP and postoperative cardiac events (OR 1.2, 95% CI 1.0-1.4, P=0.01).


CONCLUSION
Measuring NT-proBNP before non cardiac surgery in clinical practice could be useful to better stratify patients' risk.