Peptídeo natriurético tipo B como preditor de mortalidade em cirurgia cardíaca

Abstract

In the last decade, the interest in the use of B type Natriuretic Peptide (BNP) levels as a risk stratification tool in patients undergoing cardiac surgery has increased. Objective. We evaluate whether the preoperative serum concentration of BNP is a predictor of in-hospital mortality in patients undergoing cardiac surgery. Methods. We evaluated 488 consecutive patients undergoing cardiac valve surgery or coronary artery bypass grafting from January 2009 to July 2012. These were followed prospectively for 30 days postoperatively. Results. In our series, the overall mortality rate was equal to 9.6 %, ROC analysis ("Receiver Operating Charactheristic") curve found the optimal cutoff value of BNP equal to 382 pg / mL for overall mortality (AUC = 0.73, 95% CI = 0.66 to 0.81, P < 0.001). Multivariate analysis showed that the value of BNP > 382 pg / mL ( P = 0.033 , HR = 2.05, 95% CI = 1.06 to 3.98 ) was an independent predictor of overall mortality in 30 days postoperatively. Conclusion. The operative serum concentration of BNP is an independent predictor of mortality in patients undergoing valve surgery or CABG.