| The Role of Preoperative NT-proBNP in Elderly Orthopedic Patients with Normal Left Ventricular Systolic Function |
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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 |
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Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea |
| 정상 심기능을 보이는 노인 환자에서 정형외과 수술 전 NT-proBNP의 역할 |
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고은정, 문재연, 임영민, 홍원정, 신석표, 김상훈, 양우인, 성정훈, 김인재, 임상욱, 차동훈, 조승연 |
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차의과학대학교 분당차병원 심장내과 |
Correspondence:
Jae-Youn Moon, Tel: +82-31-780-5585, Fax: +82-31-780-5857, Email: answod77@naver.com
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Received: 13 August 2013 • Revised: 5 November 2013 • Accepted: 27 December 2013 |
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| This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| Abstract |
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 referred to the cardiology department for the purpose of assessing their cardiac function before orthopedic surgery. Of the patients who underwent echocardiography and NTproBNP 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. |
| Key Words:
Aged; Natriuretic peptides; Echocardiography; Orthopedics |
| 주제어:
노인; 나트륨이뇨펩티드; 심장초음파; 정형외과 |
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