Log-transformed B-type natriuretic peptide as a prognostic predictor in patients undergoing cardiovascular surgery.

Sho Takagi, Yuichiro Machida, Takashi Kobata, Daisuke Sakamoto, Shigeru Sakamoto, Tsugiyasu Kanda

Journal: The Journal of international medical research 2019;46(12):4934-4944

PMID: 30426812

Abstract

OBJECTIVE

This study was performed to explore the association between circulating B-type natriuretic peptide (BNP) and other mortality-related factors in patients undergoing cardiovascular surgery.

METHODS

In this observational study, multilevel linear regression analysis and multilevel survival analysis were performed to measure the log-transformed BNP (lnBNP) value at four time points in 197 patients with 788 repeated data measurements. Effects of the interaction between the time points and the two intervention groups (cardiac surgery and vascular surgery) were also investigated. Six models were evaluated to identify the best fit for the data. Stata/MP® version 14.2 (Stata Corp., College Station, TX, USA) was used to analyze the two-level variance component model fitting.

RESULTS

There were significant differences in the fixed-effect parameters of lnBNP, such as the time point, age, body mass index, emergency operation, prognostic nutritional index, and estimated glomerular filtration rate. According to the multilevel survival analysis for all-cause death and vascular death, lnBNP significantly differed and was a common prognostic marker.

CONCLUSION

As lnBNP increased by 1 point, all-cause death increased 2.07 times and vascular death increased 3.10 times. lnBNP is an important prognostic predictor and quantitative biochemical marker in patients undergoing cardiovascular surgery.

Address: 1 Department of Cardiovascular Surgery, Kanazawa Medical University Himi Municipal Hospital, Kurakawa, Himi, Toyama, Japan.; 2 Department of Cardiovascular Surgery, Kanazawa Medical University, Uchinada, Kahoku-gun, Ishikawa, Japan.; 3 Department of Community Medicine, Kanazawa Medical University, Uchinada, Kahoku-gun, Ishikawa, Japan.
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