The Interrelationship Between Nt-proBNP And The Scoring Systems For Evaluating The Cardiovascular Risk In Patients Undergoing Major Non-cardiac Surgery

Objective:To evaluate the interrelationship between Nt-proBNP and the marking system for evaluating the cardiovascular risk in patients undergoing major non-cardiac surgery.Methods:Plasma Nt-proBNP levels and the scores for evaluting the cardiovascular risk through the major scoring system, including ASA, NYHA, Goldman multifacotrial cardiac risk index, Revised Cardiac Risk Index and Duke Activity Status Index, were obtained in Eight-four patients before major non-cardiac surgery. Analysis the correlationship and estimate the curve to explore the interrelationship between Nt-proBNP and scoring systems.Results:Perioperative NT-proBNP level and the indices of scoring systems have a curved relationship. The Quadratic model fits smooth and steady in different situations. In Revised Cardiac Risk Index and Metabolic Equivalents system, the Compound model, Exponential model, Growth model performed better than the Quadratic model but generally they are not as steady as the Quadratic model in all the scroing systems.Conclusions:Nt-proBNP have a Curved relationship with the scoring systems for cardiac risk before noncardiac surgery. And Nt-proBNP may outperform other diagnostic tests in the future. Objective: To evaluate the predictive value of NT-proBNP for assessment of cardiac risk before non-cardiac surgery in patients with hypertension, comparing with the scoring systems for cardiac risk.Methods: Plasma Nt-proBNP levels, arterial pressure and the scores for evaluting the cardiovascular risk through the major scoring system, including ASA, NYHA, Goldman multifacotrial cardiac risk index, Revised Cardiac Risk Index and Duke Activity Status Index, were obtained in Eight-four patients before major non-cardiac surgery. Follow-up to see if the cardiac events occurred. Draw the ROC curve to judge the utility of Nt-proBNP in predicting the cardiac events in patients undergoing major non-cardiac surgery, and to see if that changes in patients with hypertension.Results: Among the 84 patients, 35 of them have a history of arterial pressure hypertension. Cardiac events occurred in 4 patients. All of them have a history of arterial pressure hypertension. Nt-proBNP gives the best result in predicting postoperative cardiac events on Reciever Operating Characteristic curve by the largest under curve area. The cut-off value is 415.9pg/ml. The sensitivity is 100%, and the specificity is 86.3%. In patients with hypertension, the cut-off value is the same, and the sensitivity is 100% but the specificity is only 77.4%. Conclusions: Nt-proBNP >415.9pg/ml identified patients at a high risk of postoperative cardiac events. There is no significant advantage in the hypertensive patients.