Preoperative <i>N</i>-Terminal Pro–B-Type Natriuretic Peptide and Cardiovascular Events After Noncardiac Surgery
Authors: Neelesh Gupta, Rajkumar Doshi, Vineet Meghrajani
Journal: Annals of Internal Medicine (2020)

Letters16 June 2020Preoperative N-Terminal Pro–B-Type Natriuretic Peptide and Cardiovascular Events After Noncardiac SurgeryNeelesh Gupta, MD, Rajkumar Doshi, MD, MPH, and Vineet Meghrajani, MDNeelesh Gupta, MDUniversity of South Alabama Medical Center, Mobile, Alabama (N.G.)Search for more papers by this author, Rajkumar Doshi, MD, MPHUniversity of Nevada, Reno, Nevada (R.D.)Search for more papers by this author, and Vineet Meghrajani, MDUniversity of Nevada, Reno, Nevada, Mount Sinai Beth Israel Hospital, New York, New York. (V.M.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-0267 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Duceppe and colleagues' study (1) shows that adding N-terminal pro–B-type natriuretic peptide (NT-proBNP) thresholds to the Revised Cardiac Risk Index improves the predictive value for the composite of vascular death and myocardial injury after noncardiac surgery within 30 days. This study is highly useful in day-to-day clinical practice and may inform guidelines. That natriuretic peptide levels are greatly affected by and inversely related to body mass index (BMI) is well documented (2). The studies done in patients with acute dyspnea show lower cutoff values for NT-proBNP (3) and proBNP (4) to diagnose heart failure. For Duceppe and ...References1. Duceppe E, Patel A, Chan MTV, et al. Preoperative N-terminal pro–B-type natriuretic peptide and cardiovascular events after noncardiac surgery. A cohort study. Ann Intern Med. 2020;172:96-104. [PMID: 31869834]. doi:10.7326/M19-2501 LinkGoogle Scholar2. Madamanchi C, Alhosaini H, Sumida A, et al. Obesity and natriuretic peptides, BNP and NT-proBNP: mechanisms and diagnostic implications for heart failure. Int J Cardiol. 2014;176:611-617. [PMID: 25156856] doi:10.1016/j.ijcard.2014.08.007 CrossrefMedlineGoogle Scholar3. Bayes-Genis A, Lloyd-Jones DM, van Kimmenade RR, et al. Effect of body mass index on diagnostic and prognostic usefulness of amino-terminal pro-brain natriuretic peptide in patients with acute dyspnea. Arch Intern Med. 2007;167:400-407. [PMID: 17325303] CrossrefMedlineGoogle Scholar4. Daniels LB, Clopton P, Bhalla V, et al. How obesity affects the cut-points for B-type natriuretic peptide in the diagnosis of acute heart failure. Results from the Breathing Not Properly Multinational Study. Am Heart J. 2006;151:999-1005. [PMID: 16644321] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of South Alabama Medical Center, Mobile, Alabama (N.G.)University of Nevada, Reno, Nevada (R.D.)University of Nevada, Reno, Nevada, Mount Sinai Beth Israel Hospital, New York, New York. (V.M.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L20-0267. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPreoperative N-Terminal Pro–B-Type Natriuretic Peptide and Cardiovascular Events After Noncardiac Surgery Emmanuelle Duceppe , Ameen Patel , Matthew T.V. Chan , Otavio Berwanger , Gareth Ackland , Peter A. Kavsak , Reitze Rodseth , Bruce Biccard , Clara K. Chow , Flavia K. Borges , Gordon Guyatt , Rupert Pearse , Daniel I. Sessler , Diane Heels-Ansdell , Andrea Kurz , Chew Yin Wang , Wojciech Szczeklik , Sadeesh Srinathan , Amit X. Garg , Shirley Pettit , Erin N. Sloan , James L. Januzzi Jr. , Matthew McQueen , Giovanna Lurati Buse , Nicholas L. Mills , Lin Zhang , Robert Sapsford , Guillaume Paré , Michael Walsh , Richard Whitlock , Andre Lamy , Stephen Hill , Lehana Thabane , Salim Yusuf , and P.J. Devereaux Preoperative N-Terminal Pro–B-Type Natriuretic Peptide and Cardiovascular Events After Noncardiac Surgery Nisha Bhudia , Ameet Bakhai , and Rachel Baumber Preoperative N-Terminal Pro–B-Type Natriuretic Peptide and Cardiovascular Events After Noncardiac Surgery Emmanuelle Duceppe , Diane Heels-Ansdell , and P.J. Devereaux Metrics 16 June 2020Volume 172, Issue 12Page: 842KeywordsBody mass indexCardiac surgeryDisclosureLongitudinal studiesN terminal pro brain natriuretic peptidesNatriuretic peptidesObesitySurgeryTreatment guidelinesVascular surgery ePublished: 16 June 2020 Issue Published: 16 June 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...