Brain natriuretic peptide is a long-term cardiovascular predictor in carotid endarterectomy

Data de publicação: 10/07/2024 Data Ahead of Print: 01/07/2024

Autores da FMUP

João Manuel Palmeira Rocha Neves

Autor

Participantes de fora da FMUP

de Gramilho, Gustavo Martim Clemente Gouveia
Pereira-Macedo, Juliana
Dias, Lara Romana Pereira
Ferreira, Ana Rita Dias
Myrcha, Piotr
Andrade, Jose Paulo Alves Vieira

Unidades de investigação

Biomedicina

Abstract

Background: In noncardiac surgery, several biomarkers are known to play a role in predicting long-term complications, such as major adverse cardiovascular events (MACE), myocardial infarction, or death. Carotid endarterectomy (CEA) is considered a low to medium-risk surgery for carotid stenosis aimed at preventing stroke events. Brain natriuretic peptide (BNP) is a biomarker with potential prognostic value regarding MACE. Since its role in patients undergoing CEA is unknown, this study aims to assess the potential role of BNP as a short and long-term predictor of all-cause mortality and MACE in patients undergoing CEA. Methods: From a prospective database, patients who underwent CEA under regional anesthesia (RA) at a tertiary hospital center were enrolled, and a post hoc analysis was conducted. Patients on which BNP levels were measured up to fifteen days before surgery, and two groups based on the BNP threshold (200 pg/mL) were defined and compared. Kaplan Meier survival curves and adjusted hazard ratios (aHR) were assessed by multivariable Cox regression. The primary outcome was the incidence of long-term MACE and all-cause mortality. Secondary outcomes included the incidence of AMI and AHF. Results: A total of 89 patients were evaluated. The mean age of the cohort was 71.2 +/- 8.7 years, with 71 (79.8%) males, and presented a median follow-up of 30 [13.5-46.4] months. BNP > 200 pg/mL has demonstrated positive predictive value for MACE (aHR: 5.569, confidence interval (CI): 2.441-12.7, p < 0.001) and all-cause mortality (aHR: 3.469, CI: 1.315-9.150, p = 0.018). Conclusion: BNP has been demonstrated to independently predict long-term all-cause mortality, MACE and AMI following CEA. It serves as a low-cost, ready-to-use biomarker, although further studies are necessary.

Dados da publicação

ISSN/ISSNe:: 0001-5458, 2577-0160
Tipo:: Article
Páginas:: 1-
DOI:: 10.1080/00015458.2024.2377889
PubMed:: 38975870

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Métricas

Filiações

de Gramilho, Gustavo Martim Clemente Gouveia:: Universidade. Univ Porto, Fac Med, Porto, Portugal
Pereira-Macedo, Juliana:: Universidade. Univ Porto, Fac Med, Porto, Portugal

Unidade Local Saude Medio Ave, Dept Surg, Vila Nova De Famalicao, Portugal

RISE Heath, Rua Dr Placido da Costa S-N, P-4200450 Porto, Portugal
Dias, Lara Romana Pereira:: Unidade Local Saude Sao Joao, Dept Angiol & Vasc Surg, Porto, Portugal
Ferreira, Ana Rita Dias:: Ctr Hosp Univ Sao Joao, Intens Care Med Dept, Porto, Portugal
Myrcha, Piotr:: Med Univ Warsaw, Fac Med, Dept Gen & Vasc Surg, Warsaw, Poland

Brodnowski Hosp, Dept Gen Vasc & Oncol Surg, Warsaw, Poland
Andrade, Jose Paulo Alves Vieira:: RISE Heath, Rua Dr Placido da Costa S-N, P-4200450 Porto, Portugal

Universidade. Univ Porto, Fac Med, Dept Biomed, Unit Anat, Porto, Portugal
da Rocha-Neves, Joao Manuel Palmeira:: RISE Heath, Rua Dr Placido da Costa S-N, P-4200450 Porto, Portugal

Unidade Local Saude Sao Joao, Dept Angiol & Vasc Surg, Porto, Portugal

Ctr Hosp Univ Sao Joao, Intens Care Med Dept, Porto, Portugal

Universidade. Univ Porto, Fac Med, Dept Biomed, Unit Anat, Porto, Portugal

Keywords

Survival analysis; carotid stenosis; major adverse cardiovascular events; heart failure; all-cause mortality