Preoperative B-type natriuretic peptides in patients undergoing noncardiac surgery: a cumulative meta-analysis

Authors

  • Lisa Ryan University of KwaZulu-Natal
  • Chantal Rajah University of KwaZulu-Natal
  • Dale Simmers University of KwaZulu-Natal
  • Danielle Potgieter University of KwaZulu-Natal
  • Reitze Nils Rodseth University of KwaZulu-Natal

Keywords:

BNP, major adverse cardiac event, myocardial injury, natriuretic peptides, non-cardiac surgery, NT-proBNP, outcomes

Abstract

Background: A plethora of studies have shown elevated preoperative natriuretic peptide measurements to predict postoperative mortality and adverse cardiac events. Objectives: The current study aimed to demonstrate this overwhelming association and to show that further studies of this nature are unwarranted. Methods: A cumulative meta-analysis of 28 studies was conducted where the primary outcomes of mortality and adverse cardiac events were associated with elevated preoperative natriuretic peptides. Results: Cumulative meta-analysis demonstrated an odds ratio trending to a constant of 5.66, with a marked narrowing in the 95% confidence interval. Conclusions: Further studies aiming only to demonstrate an association between a preoperative natriuretic peptide threshold and the risk of postoperative adverse cardiac events are not justified. Future investigation should focus on the clinical implications of these data and the application of these findings with regard to further investigation, optimisation and appropriate adaptation of perioperative management.

Author Biographies

Lisa Ryan, University of KwaZulu-Natal

Perioperative Research Group Department of Anaesthetics Grey’s Hospital Nelson R Mandela School of Medicine University of KwaZulu-Natal Pietermaritzburg South Africa

Chantal Rajah, University of KwaZulu-Natal

Perioperative Research Group Department of Anaesthetics Grey’s Hospital Nelson R Mandela School of Medicine University of KwaZulu-Natal Pietermaritzburg South Africa

Dale Simmers, University of KwaZulu-Natal

Department of Anaesthetics Nelson R Mandela School of Medicine University of KwaZulu-Natal

Danielle Potgieter, University of KwaZulu-Natal

Department of Anaesthetics Nelson R Mandela School of Medicine University of KwaZulu-Natal

Reitze Nils Rodseth, University of KwaZulu-Natal

Perioperative Research Group Department of Anaesthetics Grey’s Hospital Nelson R Mandela School of Medicine University of KwaZulu-Natal; and Department of Outcomes Research Cleveland Clinic Cleveland

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Published

2015-09-11

Issue

Section

Research Articles