Using preoperative N-terminal pro-B-type natriuretic peptide levels for predicting major adverse cardiovascular events and myocardial injury after noncardiac surgery in Chinese advan-ced-age patients
Kai ZHANG1
Chang LIU1
Jian TAN2
Yu-Hai XU3
Jiang-Bei CAO1
Yan-Hong LIU1
Qiang FU1
Jing-Sheng LOU4
Wei-Dong MI1
Hao LI1
1.Department of Anesthesiology,the First Medical Centre,Chinese PLA General Hospital,Beijing,China;Medical Sch-ool of Chinese PLA,Beijing,China2.Department of Thoracic Surgery,the Seventh Medical Centre,Chinese PLA Gen-eral Hospital,Beijing,China3.Department of Anesthesiology,Air Force Medical Center,Beijing,China4.Department of Anesthesiology,the First Medical Centre,Chinese PLA General Hospital,Beijing,China
摘要：BACKGROUND N-terminal pro-B-type natriuretic peptide (NT-proBNP) is often viewed as an indicator for heart failure. How-ever, the prognostic association and the predictive utility of NT-proBNP for postoperative major adverse cardiovascular events (MACEs) and myocardial injury after noncardiac surgery (MINS) among older patients are unclear.METHODS In this study, we included 5033 patients aged 65 years or older who underwent noncardiac surgery with preoper-ative NT-proBNP recorded. Logistic regression was adopted to model the associations between preoperative NT-proBNP and the risk of MACEs and MINS. The receiver operating characteristic curve was used to determine the predictive value of NT-proBNP. RESULTS A total of 5033 patients were enrolled, 63 patients (1.25％) and 525 patients (10.43％) had incident postoperative MACEs and MINS, respectively. Analysis of the receiver operating characteristic curve indicated that the cutoff values of ln (NT-proBNP) for MACEs and MINS were 5.16 (174 pg/mL) and 5.30 (200 pg/mL), respectively. Adding preoperative ln (NT-proBNP) to the Revised Cardiac Risk Index score and the Cardiac and Stroke Risk Model boosted the area under the receiver operating character-istic curves from 0.682 to 0.726 and 0.787 to 0.804, respectively. The inclusion of preoperative NT-proBNP in the prediction mod-els significantly increased the reclassification and discrimination. CONCLUSIONS Increased preoperative NT-proBNP was associated with a higher risk of postoperative MACEs and MINS. The inclusion of NT-proBNP enhances the predictive ability of the preexisting models.
机标关键词：chinesesurgerylevelsafteradvan-ced-ageadversecardiovascularevents
论文发表日期：2022-10-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：12( 768-779 )