Preoperative BNP as Biomarker of Postoperative Cardiovascular Complications
Condition: Postoperative Cardiovascular Complications
Study type: Observational

Summary: 
      BNP is a hormone that predicts preoperatively the occurrence of postoperative cardiovascular
      complications. In practice, the problem is that the practitioner don't know the most
      opportune moment for the preoperative sample or what threshold used to classify our patient
      in patients at risk of cardiovascular complication or not at risk.

      The purpose of this study is to determine the best time to dose the preoperative BNP with a
      specific threshold being associated with it allowing the practitioner to assess more
      accurately the post operative cardiovascular risk patients and possibly offer them strategies
      taking different load.

      The BNP will be dosed during the anesthetic consultation and the day of surgery in immediate
      preoperative operating room. Post-operative cardiovascular complications will be collected
      during hospitalization of the patient and by telephone contact on the 28th day, 90th day and
      6th postoperative months.

      The investigator then establish the threshold BNP most informative for both sampling times
      and then compare them to determine the most discriminating dosage and thus the most
      appropriate time for the determination of BNP.
    

Detailed description: 
      The morbidity and mortality of non-cardiac major surgery is mainly due to cardiovascular
      complications. BNP is a hormone for predicting preoperatively the occurrence of these
      complications. Widely used in cardiac surgery, it is not routinely used in non-cardiac major
      surgery. His interest in this type of surgery has yet been proven by numerous studies.

      In practice, the problem with this biomarker is the pratitioner do not know the most
      opportune moment for the preoperative dose or what threshold used to classify our patient
      patients at risk of cardiovascular complication or not at risk.

      Indeed, recent literature reviews are used to highlight the fact that existing studies on the
      subject using each method or BNP assay devices and heterogeneous preoperative dosing of
      different times or even BNP not exactly specified. It thus appears as many different levels
      of BNP. Practitioners did not then know when dosing the BNP and what threshold is based.

      The purpose of this study is to determine the best time to dose the preoperative BNP with a
      specific threshold being associated with it allowing the practitioner to assess more
      accurately the post operative cardiovascular risk patients and possibly offer them strategies
      taking different load.

      The BNP will be dosed during the anesthetic consultation and the day of surgery in immediate
      preoperative operating room. Post-operative cardiovascular complications will be collected
      during hospitalization of the patient and by telephone contact on the 28th day, 90th day and
      6th postoperative months.

      The investigator then establish the threshold BNP most informative for both sampling times
      and then compare them to determine the most discriminating dosage and thus the most
      appropriate time for the determination of BNP.

      There will be no immediate benefit to the patient but our study will help in the future, to
      adapt the management of perioperative patients depending on the value of pre immediate
      operative BNP to reduce postoperative complications.
    

Intervention name(s): BNP dosage
Intervention type(s): Biological
Observational model: Other
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        patient Who have to undergoing moderate or high cardiovascular risk non-ambulatory
        scheduled surgery with the exception of cardiac surgery