Is a Pre-Operative Brain Natriuretic Peptide or N-Terminal Pro-B-Type Natriuretic Peptide Measurement an Independent Predictor of Adverse Cardiovascular Outcomes Within 30 Days of Noncardiac Surgery? A Systematic Review and Meta-Analysis of Observational Studies

Objectives We conducted a systematic review and meta-analysis to determine if pre-operative brain natriuretic peptide (BNP) (i.e., BNP or N-terminal pro-B-type natriuretic peptide [NT-proBNP]) is an independent predictor of 30-day adverse cardiovascular outcomes after noncardiac surgery. Background...

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Autores: Karthikeyan, G, Moncur, RA, Levine, O, Heels-Ansdell, D, Chan, MTV, Alonso-Coello, P, Yusuf, S, Sessler, D, Villar, JC, Berwanger, O, McQueen, M, Mathew, A, Hill, S, Gibson, S, Berry, C, Yeh, HM, Devereaux, PJ
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2009
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p13105
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=13105
Access Level:acceso abierto
Palabra clave:perioperative myocardial infarction
brain natriuretic peptide
perioperative risk
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spelling Is a Pre-Operative Brain Natriuretic Peptide or N-Terminal Pro-B-Type Natriuretic Peptide Measurement an Independent Predictor of Adverse Cardiovascular Outcomes Within 30 Days of Noncardiac Surgery? A Systematic Review and Meta-Analysis of Observational StudiesKarthikeyan, GMoncur, RALevine, OHeels-Ansdell, DChan, MTVAlonso-Coello, PYusuf, SSessler, DVillar, JCBerwanger, OMcQueen, MMathew, AHill, SGibson, SBerry, CYeh, HMDevereaux, PJperioperative myocardial infarctionbrain natriuretic peptideperioperative riskObjectives We conducted a systematic review and meta-analysis to determine if pre-operative brain natriuretic peptide (BNP) (i.e., BNP or N-terminal pro-B-type natriuretic peptide [NT-proBNP]) is an independent predictor of 30-day adverse cardiovascular outcomes after noncardiac surgery. Background Pre-operative clinical cardiac risk indices have only modest predictive power. BNP predicts adverse cardiovascular outcomes in a variety of nonsurgical settings and may similarly predict these outcomes in the perioperative setting. Methods We employed 5 search strategies (e. g., searching bibliographic databases), and we included all studies that assessed the independent prognostic value of pre-operative BNP measurement as a predictor of cardiovascular complications after noncardiac surgery. We determined study eligibility and conducted data abstraction independently and in duplicate. We calculated a pooled odds ratio using a random effects model. Results Nine studies met eligibility criteria, and included a total of 3,281 patients, among whom 314 experienced 1 or more perioperative cardiovascular complications. The average proportion of patients with elevated BNP was 24.8% (95% confidence interval [CI]: 20.1 to 30.4%; I-2 = 89%). All studies showed a statistically significant association between an elevated pre-operative BNP level and various cardiovascular outcomes (e. g., a composite of cardiac death and nonfatal myocardial infarction; atrial fibrillation). Data pooled from 7 studies demonstrated an odds ratio (OR) of 19.3 (95% CI: 8.5 to 43.7; I-2 = 58%). The pre-operative BNP measurement was an independent predictor of perioperative cardiovascular events among studies that only considered the outcomes of death, cardiovascular death, or myocardial infarction (OR: 44.2, 95% CI: 7.6 to 257.0, I-2 = 51.6%), and those that included other outcomes (OR: 14.7, 95% CI: 5.7 to 38.2, I-2 = 62.2%); the p value for interaction was 0.28. Conclusions These results suggest that an elevated pre-operative BNP or NT-proBNP measurement is a powerful, independent predictor of cardiovascular events in the first 30 days after noncardiac surgery. (J Am Coll Cardiol 2009; 54: 1599-606) (C) 2009 by the American College of Cardiology FoundationELSEVIER SCIENCE INC2009info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=13105JACC-JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGYISSN: 07351097ISSNe: 15583597reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p131052026-06-14T12:41:47Z
dc.title.none.fl_str_mv Is a Pre-Operative Brain Natriuretic Peptide or N-Terminal Pro-B-Type Natriuretic Peptide Measurement an Independent Predictor of Adverse Cardiovascular Outcomes Within 30 Days of Noncardiac Surgery? A Systematic Review and Meta-Analysis of Observational Studies
title Is a Pre-Operative Brain Natriuretic Peptide or N-Terminal Pro-B-Type Natriuretic Peptide Measurement an Independent Predictor of Adverse Cardiovascular Outcomes Within 30 Days of Noncardiac Surgery? A Systematic Review and Meta-Analysis of Observational Studies
spellingShingle Is a Pre-Operative Brain Natriuretic Peptide or N-Terminal Pro-B-Type Natriuretic Peptide Measurement an Independent Predictor of Adverse Cardiovascular Outcomes Within 30 Days of Noncardiac Surgery? A Systematic Review and Meta-Analysis of Observational Studies
Karthikeyan, G
perioperative myocardial infarction
brain natriuretic peptide
perioperative risk
title_short Is a Pre-Operative Brain Natriuretic Peptide or N-Terminal Pro-B-Type Natriuretic Peptide Measurement an Independent Predictor of Adverse Cardiovascular Outcomes Within 30 Days of Noncardiac Surgery? A Systematic Review and Meta-Analysis of Observational Studies
title_full Is a Pre-Operative Brain Natriuretic Peptide or N-Terminal Pro-B-Type Natriuretic Peptide Measurement an Independent Predictor of Adverse Cardiovascular Outcomes Within 30 Days of Noncardiac Surgery? A Systematic Review and Meta-Analysis of Observational Studies
title_fullStr Is a Pre-Operative Brain Natriuretic Peptide or N-Terminal Pro-B-Type Natriuretic Peptide Measurement an Independent Predictor of Adverse Cardiovascular Outcomes Within 30 Days of Noncardiac Surgery? A Systematic Review and Meta-Analysis of Observational Studies
title_full_unstemmed Is a Pre-Operative Brain Natriuretic Peptide or N-Terminal Pro-B-Type Natriuretic Peptide Measurement an Independent Predictor of Adverse Cardiovascular Outcomes Within 30 Days of Noncardiac Surgery? A Systematic Review and Meta-Analysis of Observational Studies
title_sort Is a Pre-Operative Brain Natriuretic Peptide or N-Terminal Pro-B-Type Natriuretic Peptide Measurement an Independent Predictor of Adverse Cardiovascular Outcomes Within 30 Days of Noncardiac Surgery? A Systematic Review and Meta-Analysis of Observational Studies
dc.creator.none.fl_str_mv Karthikeyan, G
Moncur, RA
Levine, O
Heels-Ansdell, D
Chan, MTV
Alonso-Coello, P
Yusuf, S
Sessler, D
Villar, JC
Berwanger, O
McQueen, M
Mathew, A
Hill, S
Gibson, S
Berry, C
Yeh, HM
Devereaux, PJ
author Karthikeyan, G
author_facet Karthikeyan, G
Moncur, RA
Levine, O
Heels-Ansdell, D
Chan, MTV
Alonso-Coello, P
Yusuf, S
Sessler, D
Villar, JC
Berwanger, O
McQueen, M
Mathew, A
Hill, S
Gibson, S
Berry, C
Yeh, HM
Devereaux, PJ
author_role author
author2 Moncur, RA
Levine, O
Heels-Ansdell, D
Chan, MTV
Alonso-Coello, P
Yusuf, S
Sessler, D
Villar, JC
Berwanger, O
McQueen, M
Mathew, A
Hill, S
Gibson, S
Berry, C
Yeh, HM
Devereaux, PJ
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv perioperative myocardial infarction
brain natriuretic peptide
perioperative risk
topic perioperative myocardial infarction
brain natriuretic peptide
perioperative risk
description Objectives We conducted a systematic review and meta-analysis to determine if pre-operative brain natriuretic peptide (BNP) (i.e., BNP or N-terminal pro-B-type natriuretic peptide [NT-proBNP]) is an independent predictor of 30-day adverse cardiovascular outcomes after noncardiac surgery. Background Pre-operative clinical cardiac risk indices have only modest predictive power. BNP predicts adverse cardiovascular outcomes in a variety of nonsurgical settings and may similarly predict these outcomes in the perioperative setting. Methods We employed 5 search strategies (e. g., searching bibliographic databases), and we included all studies that assessed the independent prognostic value of pre-operative BNP measurement as a predictor of cardiovascular complications after noncardiac surgery. We determined study eligibility and conducted data abstraction independently and in duplicate. We calculated a pooled odds ratio using a random effects model. Results Nine studies met eligibility criteria, and included a total of 3,281 patients, among whom 314 experienced 1 or more perioperative cardiovascular complications. The average proportion of patients with elevated BNP was 24.8% (95% confidence interval [CI]: 20.1 to 30.4%; I-2 = 89%). All studies showed a statistically significant association between an elevated pre-operative BNP level and various cardiovascular outcomes (e. g., a composite of cardiac death and nonfatal myocardial infarction; atrial fibrillation). Data pooled from 7 studies demonstrated an odds ratio (OR) of 19.3 (95% CI: 8.5 to 43.7; I-2 = 58%). The pre-operative BNP measurement was an independent predictor of perioperative cardiovascular events among studies that only considered the outcomes of death, cardiovascular death, or myocardial infarction (OR: 44.2, 95% CI: 7.6 to 257.0, I-2 = 51.6%), and those that included other outcomes (OR: 14.7, 95% CI: 5.7 to 38.2, I-2 = 62.2%); the p value for interaction was 0.28. Conclusions These results suggest that an elevated pre-operative BNP or NT-proBNP measurement is a powerful, independent predictor of cardiovascular events in the first 30 days after noncardiac surgery. (J Am Coll Cardiol 2009; 54: 1599-606) (C) 2009 by the American College of Cardiology Foundation
publishDate 2009
dc.date.none.fl_str_mv 2009
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=13105
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=13105
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER SCIENCE INC
publisher.none.fl_str_mv ELSEVIER SCIENCE INC
dc.source.none.fl_str_mv JACC-JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
ISSN: 07351097
ISSNe: 15583597
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
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