Postoperative B-type Natriuretic Peptide for Prediction of Major Cardiac Events in Patients Undergoing Noncardiac Surgery Systematic Review and Individual Patient Meta-analysis
Reitze N Rodseth, Bruce M Biccard, Rong Chu, Giovana A Lurati Buse, Lehana Thabane, Ameet Bakhai, Daniel Bolliger, Lucio Cagini, Thomas J Cahill, Daniela Cardinale, Carol PW Chong, Miloslaw Cnotliwy, Salvatore Di Somma, Rene Fahrner, Wen K Lim, Elisabeth Mahla, Yannick Le Manach, Ramaswamy Manikandan, Wook B Pyun, Sriram Rajagopalan Show all
ANESTHESIOLOGY | LIPPINCOTT WILLIAMS & WILKINS | Published : 2013
BACKGROUND: It is unclear whether postoperative B-type natriuretic peptides (i.e., BNP and N-terminal proBNP) can predict cardiovascular complications in noncardiac surgery. METHODS: The authors undertook a systematic review and individual patient data meta-analysis to determine whether postoperative BNPs predict postoperative cardiovascular complications at 30 and 180 days or more. RESULTS: The authors identified 18 eligible studies (n = 2,051). For the primary outcome of 30-day mortality or nonfatal myocardial infarction, BNP of 245 pg/ml had an area under the curve of 0.71 (95% CI, 0.64-0.78), and N-terminal proBNP of 718 pg/ml had an area under the curve of 0.80 (95% CI, 0.77-0.84). Thes..View full abstract
Awarded by Ministry of Science, Belgrade, Republic of Serbia
Received from the Perioperative Research Group, Department of Anaesthetics, Inkosi Albert Luthuli Central Hospital, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa. Submitted for publication September 11, 2012. Accepted for publication February 18, 2013. Supported by a CIHR Scholarship (the Canada-HOPE Scholarship), Ottawa, Ontario, Canada; the College of Medicine of South Africa (the Phyllis Kocker/Bradlow Award), Cape Town, South Africa; and the University of KwaZulu-Natal (competitive research grant), Durban, South Africa (to Dr. Rodseth). Supported by the South African Society of Anaesthesiologists (The Jan Pretorius Research Fund), Johannesburg, South Africa, and the University of KwaZulu-Natal (competitive research grant) (to Dr. Biccard). Dr. Chong is a recipient of a National Health and Medical Research Council (Australia postgraduate research scholarship), Canberra, Australia, and has received research stipends from The University of Melbourne, Melbourne, Australia; and the Northern Clinical Research, Melbourne, Australia. Dr. Mahla has received NT-proBNP kits from Roche Diagnostics GmbH, Mannheim, Germany. She has received a study grant from Novo Nordisk Pharma GmbH, Vienna, Austria; and from CSL Behring Biotherapies for Life, Vienna, Austria. Supported by Ministry of Science, Belgrade, Republic of Serbia, research grant no. 175089 (to Dr. Radovic). Supported by a Heart and Stroke Foundation of Ontario Career Investigator Award, Ottawa, Ontario, Canada (to Dr. Devereaux). All other support was provided solely from institutional and/or departmental sources. Dr. Di Somma consults for Alere, San Diego, California. Dr Mahla has received speaker honoraria and consulting fees from CLS Behring Biotherapies for Life, Vienna, Austria. Dr. Devereaux has received a grant-in-kind from Roche Diagnostics, Basel, Switzerland, to evaluate NT-proBNP and troponin T among patients undergoing noncardiac surgery. No other author has any conflict of interest.