The Role of Preoperative NT-proBNP in Elderly Orthopedic Patients with Normal Left Ventricular Systolic Function

Eun-Jung Ko, Jae-Youn Moon, Yeong-Min Lim, Won-Jung Hong, Suk-pyo Shin, Sang-Hoon Kim, Woo-In Yang, Jung-Hoon Sung, In Jai Kim, Sang-Wook Lim, Dong-Hun Cha, Seung-Yun Cho
2014 Korean Journal of Medicine  
Background/Aims: Preoperative N-terminal pro-brain natriuretic peptide (NT-proBNP) is a useful predictor of postoperative cardiovascular complications. The present study investigated whether blood NT-proBNP values are suitable for predicting postoperative cardiovascular complications after non-cardiac surgery in elderly patients showing normal left ventricular (LV) function on preoperative echocardiograms. Methods: This study was performed by analyzing the medical records of elderly patients
more » ... erred to the cardiology department for the purpose of assessing their cardiac function before orthopedic surgery. Of the patients who underwent echocardiography and NT-proBNP assessment simultaneously, 275 patients aged ≥ 70 years and with an LV ejection fraction of ≥ 55% were included in the study. Results: Major adverse cardiac and cerebrovascular events (MACCEs) occurred in 33 (12%) of the 275 patients, and the NT-proBNP concentration was higher in patients with complications than in those without complications (1,904.20 ± 2,300.23 vs. 530.58 ± 882.27 pg/mL, p < 0.01). The ROC area under the curve was 0.756 (95% confidence interval 0.701-0.805, p < 0.001) with an optimal cutoff of 416.3 pg/mL (69.7% sensitivity, 67.36% specificity). A multivariate analysis showed that a preoperative age of > 80 years (odds ratio, 2.313; p = 0.047) and an increased blood NT-proBNP concentration (odds ratio, 3.189; p = 0.009) were independent risk factors for the prediction of MACCEs. Conclusions: Although elderly patients scheduled to undergo non-cardiac surgery may show normal LV systolic function on echocardiography, measurement of their preoperative blood NT-proBNP concentration is useful for predicting MACCEs occurring after non-cardiac surgery. (Korean J Med 2014;87:302-310)
doi:10.3904/kjm.2014.87.3.302 fatcat:jqovoqjuvnbndhximzslqsneci