Preoperative Plasma N-Terminal Pro-Brain Natriuretic Peptide Concentration and Perioperative Cardiovascular Risk in Elderly Patients
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概要
- 論文の詳細を見る
Background The prediction of perioperative cardiovascular complications is important in the medical management of patients undergoing noncardiac surgery. Several indices have been developed, but a simpler, more practical and accurate method is needed. The purpose of this study was to determine whether the N-terminal probrain natriuretic peptide (NT-proBNP) concentration before operation can be used to predict perioperative cardiovascular complications in elderly patients undergoing noncardiac surgery. Methods and Results The study group comprised 279 patients older than 60 years who were scheduled for elective surgery. The plasma NT-proBNP concentration, clinical cardiac indices and left ventricular ejection fraction were measured prior to operation. The postoperative cardiac outcomes were followed and predictors for postoperative cardiac risk were identified. Cardiovascular complications occurred in 25 patients (9.0%). Age, the incidence of prior ischemic heart disease or congestive heart failure, and the plasma NT-proBNP concentration were significantly higher in patients with perioperative cardiovascular complications than in those without. Using receiver operating characteristic analysis to predict perioperative cardiovascular events, a cut-off value of 201pg/ml was identified as the optimal predictor of perioperative complications, showing a sensitivity of 80.0% and specificity of 81.1%. Multivariate analysis revealed that NT-proBNP >201pg/ml (odds ratio (OR) 7.6, 95% confidence interval (CI) 2.2-26.6, p=0.003) and revised cardiac index ≥2 (OR 6.3, 95%CI 1.7-23.8, p=0.007) were independent predictors for perioperative cardiovascular complications. Conclusions Elevated NT-proBNP levels are independently associated with an increase in the risk of perioperative cardiovascular complications in elderly patients undergoing noncardiac and nonvascular operations.
- 社団法人日本循環器学会の論文
- 2008-01-20
著者
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Ahn Young
The Heart Center Of Chonnam National University Hospital
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JEONG Myung
The Heart Center of Chonnam National University Hospital
-
Park Eun
Department Of Biochemistry Kon Kuk University
-
Park Eun
Wonkwang University Hospital
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Jeong Myung
Yonsei University Wonju Hospital
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Oh Seouk
Gachon University Gil Medical Center
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Oh Seok
Heart Center of Chonnam National University Hospital
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Kim Nam-ho
Wonkwang University Hospital
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Kim Yong
Cardiovascular Research Institute Chonnam National University
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Jeong Jin-won
Wonkwang University Hospital
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Ahn Youngkeun
Department Of Cardiovascular Medicine Chonnam National University Medical School
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Oh Seok
Wonkwang University Hospital
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Oh Seok
Department of Cardiology, Wonkwang University Hospital
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YOO Nam
Department of Pathology, College of Medicine, Catholic University of Korea
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Kim Nam
Departments Of Cardiovascular Medicine Wonkwang University Hospital
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Park Eun
Department Of Anatomy And Cell Biology College Of Veterinary Medicine And School Of Agricultural Bio
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Yun Kyeong
Departments of Cardiovascular Medicine, Wonkwang University Hospital
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Jeong Myung
Director of Cardiac Research Laboratory, The Heart Center of Chonnam National University Hospital
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Choi Jun-Ho
Departments of Cardiovascular Medicine, Wonkwang University Hospital
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Rhee Sang
Departments of Cardiovascular Medicine, Wonkwang University Hospital
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Kim Nam-Ho
Departments of Cardiovascular Medicine, Wonkwang University Hospital
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Ahn Young
Director of Cardiac Research Laboratory, The Heart Center of Chonnam National University Hospital
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Jeong Jin-Won
Departments of Cardiovascular Medicine, Wonkwang University Hospital
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Jeong Jin-won
Departments Of Cardiovascular Medicine Wonkwang University Hospital
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Choi Jun-ho
Departments Of Cardiovascular Medicine Wonkwang University Hospital
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Choi Jun-ho
Department Of Forest Products College Of Agriculture Chonbuk National University
-
Rhee Sang
Departments Of Cardiovascular Medicine Wonkwang University Hospital
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Ahn Youngkeun
Heart Center Chonnam National University Hospital
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Yoo Nam
Wonkwang University Hospital
-
Yoo Nam
Department Of Pathology College Of Medicine Catholic University Of Korea
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Yun Kyeong
Wonkwang University Hospital
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Kim Nam-ho
Departments Of Cardiovascular Medicine Wonkwang University Hospital
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Rhee Sang
Department Of Endocrinology And Metabolism Kyung Hee University School Of Medicine
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Jeong Myung
Department Of Cardiovascular Medicine Chonnam National University Medical School
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Rhee Sang
Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital
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Yun Kyeong
Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital
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CHOI Jun-Ho
Department of Computer and Radio Communications Engineering, Korea University
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Yoo Nam
Department of Cardiovascular Medicine, Wonkwang University Hospital
-
Jeong Jin-Won
Department of Cardiovascular Medicine, Wonkwang University Hospital
-
Jeong Jin-Won
Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital
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Kim Nam-Ho
Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital
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