Preoperative B-type natriuretic peptide testing in patients undergoing noncardiac surgery.

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Authors: Rawan Rumman and Kevin Venus
Date: Oct. 11, 2022
From: CMAJ: Canadian Medical Association Journal(Vol. 194, Issue 39)
Publisher: CMA Impact Inc.
Document Type: Article
Length: 596 words
Lexile Measure: 2070L

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1 Brain natriuretic peptide (BNP) is released by ventricular cardiomyocytes in response to atrial or ventricular wall stretch, myocardial hypoxia, ischemia and fibrosis

The prohormone (proBNP) splits into the inactive N-terminal peptide (NT-proBNP) and the active hormone BNP, which decreases systemic vascular resistance and central venous pressure and increases natriuresis. Elevated BNP may be detected in patients with noncardiac conditions, such as renal failure and critical illness. (1)

2 Elevated preoperative BNP levels are associated with an increased risk of postoperative death and major cardiovascular events

A meta-analysis of 2179 patients showed that those with preoperative BNP values of 0-100, higher than 100-250 and higher than 250 ng/L experienced the composite event of all-cause 30-day mortality or nonfatal myocardial infarction at rates of 5.1%, 11.6% and 26.3%, respectively. Results were similar for patients with elevated NT-proBNP. (2)

3 Measurement of preoperative NT-proBNP adds incremental prognostic value

A 2020 cohort study of 10...

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Gale Document Number: GALE|A721426173