The Potential Predictive Value of Preoperative Brain Natriuretic Peptide Levels in Coronary Artery Bypass Grafting Surgery

Aims: The aim of this study was to assess whether preoperative and postoperative brain natriuretic peptide (BNP) levels could be used as predictors of postoperative complications and outcome in patients with coronary artery disease and ischemic heart failure undergoing on-pump or off-pump coronary artery bypass grafting surgery (CABG). Methods and Results: Fifty-eight patients (56 males and two females) with a median age of 65.3±9.9 years were included in the study. Thirty-eight patients (65.5%) underwent on-pump CABG, and 20 patients (34.5%) underwent off-pump CABG. BNP levels were determined within 24 hours before CABG and serially at 6 hours, 24 hours, 3, 7 and 30 days after CABG. Creatine phosphokinase myocardial band (CK-MB) levels were measured 1, 3, and 7 days after CABG. BNP and CK-MB levels did not differ significantly between the two groups at any time point. Preoperative BNP levels independently predicted the occurrence of cardiogenic shock and more importantly, short-term mortality. Neither preoperative left ventricular ejection fraction nor postoperative BNP or CK-MB levels at any time point showed any significant independent prognostic value for any postoperative complication. Conclusion: Our results suggest that it may be prudent to more closely monitor patients with higher preoperative BNP levels for possible postoperative complications.