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N-terminal pro B type natriuretic peptide in high cardiovascular-risk patients for noncardiac surgery: What is the current prognostic evidence?


1 Department of Anesthesiology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
2 Division of Cardiovascular and Thoracic Anesthesiology, Mayo Clinic, Arizona, USA

Correspondence Address:
Anita K Malhotra
Department of Anesthesiology, Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.179636

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Year : 2016  |  Volume : 19  |  Issue : 2  |  Page : 314-320

 

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As millions of surgical procedures are performed worldwide on an aging population with multiple comorbidities, accurate and simple perioperative risk stratification is critical. The cardiac biomarker, brain natriuretic peptide (BNP), has generated considerable interest as it is easy to obtain and appears to have powerful predictive and prognostic capabilities. BNP is currently being used to guide medical therapy for heart failure and has been added to several algorithms for perioperative risk stratification. This review examines the current evidence for the use of BNP in the perioperative period in patients who are at high-cardiovascular risk for noncardiac surgery. In addition, we examined the use of BNP in patients with pulmonary embolism and left ventricular assist devices. The available data strongly suggest that the addition of BNP to perioperative risk calculators is beneficial; however, whether this determination of risk will impact outcomes, remains to be seen.






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1 Department of Anesthesiology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
2 Division of Cardiovascular and Thoracic Anesthesiology, Mayo Clinic, Arizona, USA

Correspondence Address:
Anita K Malhotra
Department of Anesthesiology, Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.179636

Rights and Permissions

As millions of surgical procedures are performed worldwide on an aging population with multiple comorbidities, accurate and simple perioperative risk stratification is critical. The cardiac biomarker, brain natriuretic peptide (BNP), has generated considerable interest as it is easy to obtain and appears to have powerful predictive and prognostic capabilities. BNP is currently being used to guide medical therapy for heart failure and has been added to several algorithms for perioperative risk stratification. This review examines the current evidence for the use of BNP in the perioperative period in patients who are at high-cardiovascular risk for noncardiac surgery. In addition, we examined the use of BNP in patients with pulmonary embolism and left ventricular assist devices. The available data strongly suggest that the addition of BNP to perioperative risk calculators is beneficial; however, whether this determination of risk will impact outcomes, remains to be seen.






[FULL TEXT] [PDF]*


        
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