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The utility of B‐type natriuretic peptide in predicting postoperative cardiac events and mortality in patients undergoing major emergency non‐cardiac surgery

B‐type natriuretic peptide (BNP) levels predict cardiovascular risk in several settings. We hypothesised that they would identify individuals at increased risk of complications and mortality following major emergency non‐cardiac surgery. Forty patients were studied with a primary end‐point of a new postoperative cardiac event, and/or development of significant ECG changes, and/or cardiac death. The main secondary outcome was all‐cause mortality at 6 months. Pre‐operative BNP levels were higher in 11 patients who suffered a new postoperative cardiac event (p = 0.001) and predicted this outcome with an area under the receiver operating characteristic curve of 0.85 (CI = 0.72–0.98, p = 0.001). A pre‐operative BNP value > 170 pg.ml−1 has a sensitivity of 82% and a specificity of 79% for the primary end‐point. In this small study, pre‐operative BNP levels identify patients undergoing major emergency non‐cardiac surgery who are at increased risk of early postoperative cardiac events. Larger studies are required to confirm these data.