Perioperative medicine & outcomes
N-terminal Pro-BNP (NT-proBNP) or Self-Reported Functional Capacity in Estimating Risk of Cardiovascular Events After Noncardiac Surgery
Authors' conclusion
In this cohort study of nearly 3600 patients with elevated cardiovascular risk undergoing noncardiac surgery, there was no conclusive evidence of a difference between a NT-proBNP-based and a self-reported functional capacity-based estimate of MACE risk.
Study context
- Population
- Patients undergoing inpatient elective noncardiac surgery at 25 tertiary care hospitals in Europe, 2017–2020; aged ≥45 y with Revised Cardiac Risk Index (RCRI) ≥2 or NSQIP MICA >1%, or aged ≥65 y with intermediate- or high-risk procedures3,597 with complete data
- Participants
- 3,731 patients
- Exposure
- NT-proBNP vs self-reported functional capacity added to clinical scores (RCRI, age, 4MET) to estimate major adverse cardiac events (MACE) risk
- Outcome
- MACE:
- In-hospital CV mortality
- Cardiac arrest
- MI
- Stroke
- HF requiring transfer to higher unit of care
- Follow-up
- In-hospital
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Discrimination for MACE (AUC)
RCRI, age, and 4MET
0.704
AUC · 95% CI 0.646–0.763
Plus floor climbing
0.702
AUC · 95% CI 0.645–0.760
Plus physical activity
0.724
AUC · 95% CI 0.672–0.775
Plus NT-proBNP
0.736
AUC · 95% CI 0.682–0.790
- MACE incidence
- 86 [2.4%]
Observational data: associations, not effects.
Further findings
Benefit analysis
- Favoured NT-proBNP at a threshold of 5% or below (true positives valued ≥20 times false positives)
NSQIP MICA as baseline clinical score
- Findings similar
Original publication
NT-proBNP or Self-Reported Functional Capacity in Estimating Risk of Cardiovascular Events After Noncardiac Surgery. JAMA Netw Open. Published 1 November 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →