N-Terminal B-Natriuretic Peptide After Coronary Artery Bypass Graft Surgery

Objective To investigate N-terminal amino-acid sequence of the B-natriuretic peptide (NT-proBNP) release and its prognostic characteristics after coronary artery bypass graft surgery with and without cardiopulmonary bypass. Design Observational study. Setting Teaching hospital. Participants One hundred eighty-four patients. Interventions The authors determined plasma concentrations of NT-proBNP just before anesthesia induction and 24 hours after the end of the surgery. Measurements and Main Results NT-proBNP concentrations (median [interquartile range]) increased from 270 (75-716) pg/mL preoperatively to 1,664 (978-3,193) pg/mL on postoperative day 1 ( p < 0.001), and all postoperative values were higher than the preoperative ones. NT-proBNP concentrations at day 1 were correlated to those at day 0 ( r2 = 0.34, p < 0.001). Patients showing elevated concentration of cTnI at day 1 (>14 ng/mL) had significantly ( p = 0.04) higher plasma NT-proBNP levels than patients with a low cardiac troponin I concentration. Patients with prolonged intensive care unit (ICU) stay (>4 days) showed at day 1 significantly higher ( p = 0.003) plasma NT-proBNP levels than patients with ICU stay