Preoperative B-type natriuretic peptide, and not the inflammation status, predicts an adverse outcome for patients undergoing heart surgery

dc.creatorGanem, F
dc.creatorSerrano, CV
dc.creatorFernandes, JL
dc.creatorBlotta, MHSL
dc.creatorSouza, JA
dc.creatorNicolau, JC
dc.creatorRamires, JAF
dc.creatorHueb, WA
dc.date2011
dc.dateMAY
dc.date2014-08-01T18:34:37Z
dc.date2015-11-26T18:03:57Z
dc.date2014-08-01T18:34:37Z
dc.date2015-11-26T18:03:57Z
dc.date.accessioned2018-03-29T00:46:00Z
dc.date.available2018-03-29T00:46:00Z
dc.identifierInteractive Cardiovascular And Thoracic Surgery. Oxford Univ Press, v. 12, n. 5, n. 778, n. 783, 2011.
dc.identifier1569-9293
dc.identifierWOS:000309996400040
dc.identifier10.1510/icvts.2010.255257
dc.identifierhttp://www.repositorio.unicamp.br/jspui/handle/REPOSIP/80992
dc.identifierhttp://repositorio.unicamp.br/jspui/handle/REPOSIP/80992
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1292707
dc.descriptionFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
dc.descriptionObjectives: B-type natriuretic peptide (BNP) and inflammatory markers are implicated in the pathophysiology of both ischemic cardiomyopathy and complications after cardiac surgery with cardiopulmonary bypass (CPB). The purpose of this study was to assess preoperative and postoperative levels of BNP, interleukin-6 (IL-6), interleukin-8 (IL-8), P-selectin, intercellular adhesion molecule (ICAM), C-reactive protein (CRP) in patients undergoing cardiac surgery with CPB and investigate their variation and ability to correlate with immediate outcome. Methods: Plasma levels of these markers were measured preoperatively, 6 and 24 h after CBP in 62 patients. Main endpoints were requirements for intra-aortic balloon pump, intensive care unit (ICU) stay longer than five days, ventilator dependence >24 h, requirement for dobutamine, hospital stay >10 days, clinical complications (infection, myocardial infarction, renal failure, stroke and ventricular arrhythmias) and in-hospital mortality. Results: Preoperative BNP levels correlate with longer ICU stay (P=0.003), longer ventilator use (P=0.018) and duration of dobutamine use (P<0.001). The receiver-operating characteristic curve demonstrated BNP levels >190 pg/ml as predictor of ICU >5 days and BNP levels >20.5 pg/ml correlated with dobutamine use, with areas under the curve of 0.712 and 0.842, respectively. Preoperative levels of ICAM-1 were associated with in-hospital mortality (P=0.042). In the postoperative period, was found association between CRP, IL-6 and P-selectin with ventilation duration (P=0.013, P=0.006, P<0.001, respectively) and P-selectin with ICU stay (P=0.009). Conclusions: BNP correlates with clinical endpoints more than inflammatory markers and can be used as a predictor of early outcome after heart surgery. (C) 2011 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.
dc.description12
dc.description5
dc.description778
dc.description783
dc.descriptionFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
dc.descriptionFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
dc.descriptionFAPESP [2002/08301-5]
dc.languageen
dc.publisherOxford Univ Press
dc.publisherOxford
dc.publisherInglaterra
dc.relationInteractive Cardiovascular And Thoracic Surgery
dc.relationInteract Cardiovasc. Thorac. Surg.
dc.rightsfechado
dc.rightshttp://www.oxfordjournals.org/access_purchase/self-archiving_policyb.html
dc.sourceWeb of Science
dc.subjectIschemic cardiomyopathy
dc.subjectBrain natriuretic peptide
dc.subjectInflammation markers
dc.subjectHeart surgery
dc.subjectC-reactive Protein
dc.subjectCoronary-artery-disease
dc.subjectCardiac-surgery
dc.subjectCardiopulmonary Bypass
dc.subjectTherapeutic Strategies
dc.subjectMechanisms
dc.subjectMortality
dc.subjectRisk
dc.subjectAtherosclerosis
dc.subjectStratification
dc.titlePreoperative B-type natriuretic peptide, and not the inflammation status, predicts an adverse outcome for patients undergoing heart surgery
dc.typeArtículos de revistas


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