The influence of clinical risk factors on pre-operative B-type natriuretic peptide risk stratification of vascular surgical patients.

Abstract:

:The role of the revised cardiac risk index in risk stratification has recently been challenged by studies reporting on the superior predictive ability of pre-operative B-type natriuretic peptides. We found that in 850 vascular surgical patients initially risk stratified using B-type natriuretic peptides, reclassification with the number of revised cardiac risk index risk factors worsened risk stratification (p < 0.05 for > 0, > 2, > 3 and > 4 risk factors, and p = 0.23 for > 1 risk factor). When evaluated with pre-operative B-type natriuretic peptides, none of the revised cardiac risk index risk factors were independent predictors of major adverse cardiac events in vascular patients. The only independent predictor was B-type natriuretic peptide stratification (OR 5.1, 95% CI 1.8-15 for the intermediate class, and OR 25, 95% CI 8.7-70 for the high-risk class). The clinical risk factors in the revised cardiac risk index cannot improve a risk stratification model based on B-type natriuretic peptides.

journal_name

Anaesthesia

journal_title

Anaesthesia

authors

Biccard BM,Lurati Buse GA,Burkhart C,Cuthbertson BH,Filipovic M,Gibson SC,Mahla E,Leibowitz DW,Rodseth RN

doi

10.1111/j.1365-2044.2011.06958.x

subject

Has Abstract

pub_date

2012-01-01 00:00:00

pages

55-9

issue

1

eissn

0003-2409

issn

1365-2044

journal_volume

67

pub_type

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