Department of Cardiovascular Surgery, General Hospital of Ningxia Medical University, Yinchuan 750004, China.
Department of Cardiovascular Surgery, General Hospital of Ningxia Medical University, Yinchuan 750004, China.
Transpl Immunol. 2022 Jun;72:101563. doi: 10.1016/j.trim.2022.101563. Epub 2022 Mar 4.
This study aims to investigate the correlation between the postoperative changes in serum amino-terminal pro-brain natriuretic peptide (NT-proBNP) levels and the prognosis of patients with off-pump coronary artery bypass grafting.
The patients were divided into two groups according to the left ventricular ejection fraction (LVEF) value of their cardiac ultrasound 48 h after surgery: the study group, those with early postoperative cardiac dysfunction (LVEF ≤45%, 36 cases), and the control group, those without early postoperative cardiac dysfunction (LVEF >45%, 60 cases). The serum NT-proBNP levels at 24 h and 48 h after surgery and before discharge were measured in the two groups, and any major postoperative adverse events were observed to analyze the relationship between the NT-proBNP levels and early postoperative cardiac dysfunction and prognosis.
The serum NT-proBNP levels in the study group were significantly higher than in the control group at 24 h and 48 h after surgery (p < 0.05). However, there was no significant difference between the two groups in the serum NT-proBNP levels before discharge (p > 0.05). The main adverse events of the study group during hospitalization were significantly higher than in the control group (p < 0.05). The area under the curve of NT-proBNP in predicting early postoperative cardiac dysfunction was 0.850 (95% CI: 0.826-0.903) (p < 0.001). The best diagnostic value was 5653.95 pg/ml, the sensitivity was 87.8%, and the specificity was 83.6%.
The postoperative NT-proBNP level is closely related to early cardiac dysfunction and major adverse events after off-pump coronary artery bypass grafting.
本研究旨在探讨非体外循环冠状动脉旁路移植术后血清氨基末端脑利钠肽前体(NT-proBNP)水平变化与患者预后的相关性。
根据术后 48 小时心脏超声左心室射血分数(LVEF)值,将患者分为两组:研究组为术后早期心功能障碍组(LVEF≤45%,36 例),对照组为无术后早期心功能障碍组(LVEF>45%,60 例)。测量两组患者术后 24 小时和 48 小时及出院前的血清 NT-proBNP 水平,并观察术后任何主要不良事件,分析 NT-proBNP 水平与术后早期心功能障碍及预后的关系。
研究组术后 24 小时和 48 小时血清 NT-proBNP 水平明显高于对照组(p<0.05),但两组出院前血清 NT-proBNP 水平差异无统计学意义(p>0.05)。研究组住院期间主要不良事件发生率明显高于对照组(p<0.05)。NT-proBNP 预测术后早期心功能障碍的曲线下面积为 0.850(95%CI:0.826-0.903)(p<0.001)。最佳诊断值为 5653.95pg/ml,灵敏度为 87.8%,特异性为 83.6%。
非体外循环冠状动脉旁路移植术后 NT-proBNP 水平与术后早期心功能障碍及主要不良事件密切相关。