REDUCING GLOBAL PERIOPERATIVE RISK
This resource center is jointly hosted by The American Journal of Medicine,
The American Journal of Cardiology, and the Canadian Journal of Cardiology.
key Findings
- The overall incidence of the composite of death and non-fatal myocardial infarction at 30 days was 10.8% (235 events).
- NP threshold values associated with lowest p value for death and myocardial infarction for BNP was 92 ng/L and for NT-proBNP was 300 ng/L.
- The incidence of death and non-fatal myocardial infarction at 30 days was 21.8% in patients who had a positive preoperative NT-proBNP (≥300 ng/L ) or BNP (≥92 ng/L), compared to 4.9% in patients who had a negative preoperative NT-proBNP (<300 ng/L) or BNP (<92 ng/L).
- The overall absolute net reclassification showed that in a sample of 1000 patients, a preoperative NP measurement will result in a more appropriate risk estimate in 155 patients compared to a clinical model (ie, Revised Cardiac Risk Index).
- The 2016 Canadian Cardiology Society Guidelines on perioperative risk prediction and management recommends measuring BNP or NT-proBNP before surgery to enhance perioperative cardiac risk estimation in patients who are ≥65 years of age, are 45 to 64 years of age with significant cardiovascular disease, or have a Revised Cardiac Risk Index (RCRI) score ≥1.
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