Pre-Operative N-Terminal Pro-Brain Natriuretic Peptide Predicts Outcome in Type A Aortic Dissection
Gottfried Sodeck, MD*,
Hans Domanovits, MD*,*,
Martin Schillinger, MD ,
Karin Janata, MD*,
Markus Thalmann, MD ,
Marek P. Ehrlich, MD,
Georg Endler, MD and
Anton Laggner, MD*
* Department of Emergency Medicine, Medical University Vienna, Vienna, Austria
Department of Angiology, Medical University Vienna, Vienna, Austria
Department of Cardiothoracic Surgery, Medical University Vienna, Vienna, Austria
Department of Laboratory Medicine, Medical University Vienna, Vienna, Austria.
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Figure 1 Pre-Operative NT-proBNP as Outcome Predictor in Surgery for Acute Type A Aortic Dissection
Pre-operative NT-proBNP in 104 patients undergoing emergency surgical repair of type A aortic dissection with respect to post-operative occurrence of major adverse events and 30-day mortality. Plots indicate median and interquartile range (range from the 25th to the 75th percentile). Major adverse event was defined as composite end point, including need for rethoracotomy, occurrence of post-operative heart failure, neurologic deficit, lung failure, renal failure, or sepsis. MAE = major adverse event; NT-proBNP = N-terminal pro-brain natriuretic peptide.
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Figure 2 Pre-Operative NT-proBNP Predicts 30-Day Post-Operative Outcome After Adjustment for the Time Onset of Symptoms and the Logistic EuroSCORE
Adjusted odds ratios (OR) (diamonds) and 95% confidence intervals (CIs) (solid lines) comparing N-terminal pro-brain natriuretic peptide (NT-proBNP) levels on admission (in tertiles) and occurrence of major adverse events or death within a 30-day post-operative observation period. Major adverse event was defined as composite end point, including need for rethoracotomy, occurrence of post-operative heart failure, neurologic deficit, lung failure, renal failure, or sepsis. Final models were adjusted for logistic EuroSCORE and time of onset of symptoms. EuroSCORE = European System for Cardiac Operative Risk Evaluation.
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Figure 3 Pre-Operative NT-proBNP Predicts 30-Day Postoperative Outcome After Adjustment for the Time Onset of Symptoms and the Individual Patient’s Risk Profile
Adjusted ORs (diamonds) and 95% CIs (solid lines) comparing NT-proBNP levels on admission (in tertiles) and occurrence of major adverse events or death within a 30-day post-operative observation period. Major adverse event was defined as composite end point, including need for rethoracotomy, occurrence of post-operative heart failure, neurologic deficit, lung failure, renal failure, or sepsis. Final models were adjusted for "gender," "time onset of symptoms," "pulmonary hypertension," "impaired left ventricular function," "critical pre-operative state," and "impaired renal function." Abbreviations as in Figure 2.
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