Prognostic significance of atrial natriuretic peptide in patients undergoing cardiac surgery

B.A. Akselrod

Petrovsky National Research Center of Surgery

ORCID: 0000-0002-4434-3123

A.V. Gubko

Petrovsky Russian Scientific Center of Surgery

ORCID: 0000-0003-1477-2207

O.V. Dymova

Petrovsky Russian Scientific Center of Surgery

ORCID: 0000-0003-2008-6350

D.A. Guskov

Petrovsky Russian Scientific Center of Surgery

ORCID: 0000-0001-6974-8402

A.P. Krasnoshchekova

Petrovsky Russian Scientific Center of Surgery

ORCID: 0000-0001-6986-1368

K.V. Gubko

Petrovsky Russian Scientific Center of Surgery

ORCID: 0000-0002-0160-4223

Prognostic significance of atrial natriuretic peptide in patients undergoing cardiac surgery

Authors:

B.A. Akselrod, A.V. Gubko, O.V. Dymova, D.A. Guskov, A.P. Krasnoshchekova, K.V. Gubko

More about the authors

Journal: Russian Journal of Anesthesiology and Reanimatology. 2023;(6): 36‑42

DOI: 10.17116/anaesthesiology202306136

Downloaded: 55

To cite this article:

Akselrod BA, Gubko AV, Dymova OV, Guskov DA, Krasnoshchekova AP, Gubko KV. Prognostic significance of atrial natriuretic peptide in patients undergoing cardiac surgery. Russian Journal of Anesthesiology and Reanimatology. 2023;(6):36‑42. (In Russ., In Engl.)
https://doi.org/10.17116/anaesthesiology202306136

Доказательная гастроэнтерология: pro et contra

Актуальные вопросы педиатрической практики

Использование инфографики авторами научных работ

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BACKGROUND

Nowadays, atrial natriuretic peptide is more often used to determine severity and predict treatment outcomes in patients with cardiac failure and/or atrial fibrillation. Atrial natriuretic peptide was described as prognostic marker of postoperative complications in cardiac surgery patients. However, available data are insufficient and inspired this study.

OBJECTIVE

To determine the correlation between intraoperative pro-ANP dynamics and postoperative complications in cardiac surgery patients.

MATERIAL AND METHODS

There were 81 cardiac surgery patients. Inclusion criteria were thoracic aorta repair, coronary artery bypass surgery, valve procedures, etc. Blood samples were taken at 4 stages: before induction of anesthesia, before and after cardiopulmonary bypass, at the end of surgery.

RESULTS

There was a relationship between pro-ANP level and the number of patients (25 out of 81) with ≥1 postoperative complications. Complicated postoperative period is characterized by higher pro-ANP after cardiopulmonary bypass (224.05 [198; 282] pg/ml and 173.45 [112; 266] pg/ml, respectively, p=0.0391). Risk factors of postoperative complications were pro-ANP after cardiopulmonary bypass >180.5 pg/ml (OR 9.722, CI 2.554—37.004, p=0.0007) and pro-ANP increment by more than 1.46 times throughout cardiopulmonary bypass (OR 4.259, CI 1.380—13.147, p=0.010). Patients with postoperative vascular insufficiency are characterized by higher pro-ANP at the end of cardiopulmonary bypass (254.90 (215.20—326.00) pg/ml and 196.00 (115.60—263.90) pg/ml, respectively, p=0.028). Risk factor of postoperative vascular insufficiency is pro-ANP before cardiopulmonary bypass >124.15 pg/ml (OR 6.058, CI 1.141—32.175, p=0.032).

CONCLUSION

Increased pro-ANP after cardiopulmonary bypass is associated with higher incidence of postoperative complications. Pro-ANP before cardiopulmonary bypass >124.15 pg/ml is a risk factor of postoperative vascular insufficiency. Pro-ANP increment after cardiopulmonary bypass compared to baseline value is associated with length of hospital-stay.

Keywords:

cardiac surgery

biomarkers

atrial natriuretic peptide

complications

vascular insufficiency

Authors:

B.A. Akselrod

Petrovsky National Research Center of Surgery

ORCID: 0000-0002-4434-3123

A.V. Gubko

Petrovsky Russian Scientific Center of Surgery

ORCID: 0000-0003-1477-2207

O.V. Dymova

Petrovsky Russian Scientific Center of Surgery

ORCID: 0000-0003-2008-6350

D.A. Guskov

Petrovsky Russian Scientific Center of Surgery

ORCID: 0000-0001-6974-8402

A.P. Krasnoshchekova

Petrovsky Russian Scientific Center of Surgery

ORCID: 0000-0001-6986-1368

K.V. Gubko

Petrovsky Russian Scientific Center of Surgery

ORCID: 0000-0002-0160-4223

Received:

25.05.2023

Accepted:

17.06.2023

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