Perioperative Levels of Troponin and BNP and the Outcome after Coronary Artery Bypass Grafting

Authors

  • Ayman R. Abdelrehim Cardiac Surgery Department, Madina Cardiac Center, 42364 Madina, Saudi Arabia; Cardiothoracic Surgery Department Faculty of Medicine, Menoufia University, 32111 Menoufia, Egypt https://orcid.org/0000-0002-1947-2839
  • Faisal A. Alnasser Cardiology Department, Madina Cardiac Center, 42364 Madina, Saudi Arabia
  • Fareed A. Alnozaha Cardiology Department, Madina Cardiac Center, 42364 Madina, Saudi Arabia
  • Mohammadnizam S.H. Uddin Cardiac Anesthesia Department, Madina Cardiac Center, 42364 Madina, Saudi Arabia
  • Hasan I. Sandogji Cardiac Surgery Department, Madina Cardiac Center, 42364 Madina, Saudi Arabia
  • Hussain R. Aynusah Research Department, Taibah University, 42364 Madina, Saudi Arabia
  • Asim S.S. Alluhaybi Research Department, Taibah University, 42364 Madina, Saudi Arabia
  • Refal A. Alahmadi Research Department, Taibah University, 42364 Madina, Saudi Arabia
  • Hussam M. Alahmadi Research Department, Taibah University, 42364 Madina, Saudi Arabia
  • Wafaa M. Alharbi Research Department, Madina Cardiac Center, 42364 Madina, Saudi Arabia
  • Ahmed M. Shabaan Cardiac Surgery Department, Madina Cardiac Center, 42364 Madina, Saudi Arabia; Cardiothoracic Surgery Department Faculty of Medicine, 41522 Suez Canal University, Egypt

DOI:

https://doi.org/10.1532/hsf.5471

Keywords:

atrial natriuretic peptide, cardiac troponin I, coronary artery bypass grafting, prognosis

Abstract

Background: The independent predictive values of troponin I (cTnI) and B-type natriuretic peptide (BNP) after coronary artery bypass grafting (CABG) have been reported in several studies. However, adjustment only has been limited to preoperative risk factors. Aim: This study was conducted to assess the independent values of postoperative cTnI and BNP to predict the outcome after CABG with adjustment for preoperative risk estimates and postoperative complications and to report risk stratification gains, when considering the European System for Cardiac Operative Risk Evaluation (EuroSCORE) combined with postoperative biomarkers. Methods: This retrospective cohort study included 282 consecutive patients undergoing CABG between January 2018 and December 2021. We evaluated the preoperative and postoperative cTnI and BNP, EuroSCORE, and postoperative complications. The composite endpoint was death or cardiac-related adverse events. Results: The AUROC for postoperative cTnI was significantly higher than that of BNP (0.777 vs. 0.625, p = 0.041). The optimal cut-off values to predict the composite outcome were >4830 (pg/mL) and >6.95 (ng/mL) for BNP and cTnI, respectively. Adjustment for relevant and significant perioperative factors showed that postoperative BNP and cTnI had a high discriminatory power (C-index = 0.773 and 0.895, respectively) for predicting major adverse events. Conclusions: Postoperative BNP and cTnI are independent predictors of death or major adverse events, following CABG, and can add to the predictive power of EuroSCORE II.

Author Biographies

Faisal A. Alnasser, Cardiology Department, Madina Cardiac Center, 42364 Madina, Saudi Arabia

Cardiology Department, Madina Cardiac Center, Madina, Saudi Arabia

Fareed A. Alnozaha, Cardiology Department, Madina Cardiac Center, 42364 Madina, Saudi Arabia

Cardiology Department, Madina Cardiac Center, Madina, Saudi Arabia

Mohammadnizam S.H. Uddin, Cardiac Anesthesia Department, Madina Cardiac Center, 42364 Madina, Saudi Arabia

Cardiac Anesthesia Department, Madina Cardiac Center, Madina, Saudi Arabia;

Hasan I. Sandogji, Cardiac Surgery Department, Madina Cardiac Center, 42364 Madina, Saudi Arabia

Cardia surgery Department, Madina Cardiac Center, Madina, Saudi Arabia

Hussain R. Aynusah, Research Department, Taibah University, 42364 Madina, Saudi Arabia

Taibah University.

Asim S.S. Alluhaybi, Research Department, Taibah University, 42364 Madina, Saudi Arabia

Taibah University.

Refal A. Alahmadi, Research Department, Taibah University, 42364 Madina, Saudi Arabia

Taibah University.

Hussam M. Alahmadi, Research Department, Taibah University, 42364 Madina, Saudi Arabia

Taibah University.

Wafaa M. Alharbi, Research Department, Madina Cardiac Center, 42364 Madina, Saudi Arabia

Research Department, Madina Cardiac Center, Madina, Saudi Arabia

Ahmed M. Shabaan, Cardiac Surgery Department, Madina Cardiac Center, 42364 Madina, Saudi Arabia; Cardiothoracic Surgery Department Faculty of Medicine, 41522 Suez Canal University, Egypt

Cardiac surgery Department, Madina Cardiac Center, Madina, Saudi Arabia

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Published

2023-05-31

How to Cite

Abdelrehim, A. R., Alnasser, F. A., Alnozaha, F. A., Uddin, M. S., Sandogji, H. I., Aynusah, H. R., Alluhaybi, A. S., Alahmadi, R. A., Alahmadi, H. M., Alharbi, W. M., & Shabaan, A. M. (2023). Perioperative Levels of Troponin and BNP and the Outcome after Coronary Artery Bypass Grafting. The Heart Surgery Forum, 26(3), E240-E248. https://doi.org/10.1532/hsf.5471

Issue

Vol. 26 No. 3 (2023)

Section

Article
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