Preoperative high-sensitive troponin T and N-terminal pro B-type natriuretic peptide in prediction of short-term mortality after non-cardiac surgery (High-sensitive troponin T and N-terminal pro B-type natriuretuc peptide in prediciton of mortality after non-cardiac surgery)

Abstract

Background and Aims: The aim of this study was to evaluate potential of prognostic cardiac biomarkers by predicting fatal events during perioperative period and the significance of their increased values in all patients and with coronary artery disease (CAD). Methods: The study included 87 patients who underwent major abdominal and vascular surgery. Blood samples were taken from all patients prior to surgery and levels of high-sensitive troponin T (hsTnT) and N-Terminal Pro B-type natriuretic peptide (NT-proBNP) were measured. It was analyzed how their increased values (above the predefined cut-offs of > 14 ng/L and > 300 pg/mL respectively) was associated with perioperative mortality in both all subjects and in patients with CAD. Results: Median value of hsTnT in survival group was 11.29 ng/L (interquartile range - IQR, 6.03-18.57) vs. 26.62 ng/L (IQR, 21.48-76.31) in non-survival group, p = 0.045 and for NT-proBNP in survival group was 259.05 pg/mL (IQR, 93.03-447.45) vs. 759.2 pg/mL (IQR, 433-6095) in non-survival group, p = 0.017. The odds ratio of mortality was presented in the form of direct association for both measured biomarkers - not only in patients with CAD but also in all included patients. Conclusions: Preoperatively increased hsTnT and NT-proBNP indicate high mortality risk during perioperative period. Because of the association between increased cardiac biomarker and mortality events in patients with CAD, special attention is necessary in preparation for major surgery.

Keywords

• cardiac biomarkers
• short-term mortality
• perioperative risk
• non-cardiac surgery
• coronary artery disease