Brain natriuretic peptide is a long-term cardiovascular predictor in carotid endarterectomy

• Type: Article in International Scientific Journal
• Date: 2024

Authors

de Gramilho, GMCG (Author) Other; Pereira-Macedo, J (Author) Other; Dias, LRP (Author) Other; Ferreira, ARD (Author) Other; Myrcha, P (Author) Other; Andrade, JPAV (Author) Other; da Rocha-Neves, JMP (Author) FMUP

Journal

Title: Acta Chirurgica Belgica

Pages: 1-25

ISSN: 0001-5458

Publisher: Taylor & Francis

Indexing

ISI Web of Knowledge - 0 Citations

Scopus - 0 Citations

Other information

Authenticus ID: P-010-QHC

DOI: 10.1080/00015458.2024.2377889

Abstract (EN): Background: In noncardiac surgery, several biomarkers are known to play a role in predicting long-term complications, such as major adverse cardiovascular events (MACE), myocardial infarction, or death. Carotid endarterectomy (CEA) is considered a low to medium-risk surgery for carotid stenosis aimed at preventing stroke events. Brain natriuretic peptide (BNP) is a biomarker with potential prognostic value regarding MACE. Since its role in patients undergoing CEA is unknown, this study aims to assess the potential role of BNP as a short and long-term predictor of all-cause mortality and MACE in patients undergoing CEA. Methods: From a prospective database, patients who underwent CEA under regional anesthesia (RA) at a tertiary hospital center were enrolled, and a post hoc analysis was conducted. Patients on which BNP levels were measured up to fifteen days before surgery, and two groups based on the BNP threshold (200 pg/mL) were defined and compared. Kaplan Meier survival curves and adjusted hazard ratios (aHR) were assessed by multivariable Cox regression. The primary outcome was the incidence of long-term MACE and all-cause mortality. Secondary outcomes included the incidence of AMI and AHF. Results: A total of 89 patients were evaluated. The mean age of the cohort was 71.2 +/- 8.7 years, with 71 (79.8%) males, and presented a median follow-up of 30 [13.5-46.4] months. BNP > 200 pg/mL has demonstrated positive predictive value for MACE (aHR: 5.569, confidence interval (CI): 2.441-12.7, p < 0.001) and all-cause mortality (aHR: 3.469, CI: 1.315-9.150, p = 0.018). Conclusion: BNP has been demonstrated to independently predict long-term all-cause mortality, MACE and AMI following CEA. It serves as a low-cost, ready-to-use biomarker, although further studies are necessary.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 7