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B型利钠肽作为体外循环冠状动脉旁路移植术短期死亡率的预测指标

B-Type Natriuretic Peptide as a Predictor of Short-Term Mortality in On-Pump Coronary Artery Bypass Grafting.

作者信息

Murad Jamil Alli, Machado Maurício Nassau, Fernandes Marcio Pimentel, Soares Marcelo José Ferreira, Grigolo Ingrid Helen, Singulane Cristiane Carvalho, Godoy Moacir Fernandes de

机构信息

Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, SP, Brazil.

出版信息

Braz J Cardiovasc Surg. 2017 Nov-Dec;32(6):462-467. doi: 10.21470/1678-9741-2017-0154.

Abstract

OBJECTIVE

The present study refers to a determination of the preoperative B-type natriuretic peptide is a predictor of short-term all-cause mortality in patients undergoing on-pump coronary artery bypass graft surgeries.

METHODS

Two hundred and twenty-one patients undergoing on-pump coronary artery bypass graft surgeries were evaluated prospectively during a 30-day postoperative follow-up period. Serum B-type natriuretic peptide concentration was measured without a 24-hour period prior to the surgical procedure and the value obtained was correlated with a short-term all-cause mortality.

RESULTS

Data analysis showed that all-cause mortality rates were equal to 9.5% in 30 days. Accuracy analysis by the receiver operating characteristic curve found an ideal cut-off value of B-type natriuretic peptide equal to 150 pg/mL in relation to mortality (AUC=0.82, 95% CI=0.71-0.87, P<0.001). Multivariate analysis showed that B-type natriuretic peptide value greater than or equal to 150 pg/mL (P=0.030, HR=3.99, 95% CI=1.14-13.98) was an independent predictor of all-cause mortality in a 30-day follow-up period.

CONCLUSION

Preoperative serum B-type natriuretic peptide concentration is an independent predictor of short-term all-cause mortality in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass.

摘要

目的

本研究旨在确定术前B型利钠肽是否为接受体外循环冠状动脉搭桥手术患者短期全因死亡率的预测指标。

方法

对221例接受体外循环冠状动脉搭桥手术的患者进行前瞻性评估,随访术后30天。在手术前24小时内测量血清B型利钠肽浓度,并将所得值与短期全因死亡率相关联。

结果

数据分析显示,30天内全因死亡率为9.5%。通过受试者工作特征曲线进行的准确性分析发现,与死亡率相关的B型利钠肽理想临界值为150 pg/mL(AUC=0.82,95%CI=0.71-0.87,P<0.001)。多变量分析显示,B型利钠肽值大于或等于150 pg/mL(P=0.030,HR=3.99,95%CI=1.14-13.98)是30天随访期内全因死亡率的独立预测指标。

结论

术前血清B型利钠肽浓度是接受体外循环冠状动脉搭桥手术患者短期全因死亡率的独立预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8455/5731322/f2026acf1a9d/rbccv-32-06-0462-g01.jpg

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