# N-terminal Pro-brain Natriuretic Peptide as a Prognostic Biomarker for Cardiac Surgeries: A Systematic Review

## TL;DR

This study reviews how high levels of NT-proBNP before heart surgery can predict poor outcomes like mortality and complications.

## Contribution

The study systematically evaluates NT-proBNP as an independent predictor of adverse outcomes in cardiac surgery patients.

## Key findings

- Preoperative NT-proBNP levels predict mortality and ICU length of stay after heart surgery.
- Elevated NT-proBNP is linked to postoperative complications like acute kidney injury and atrial fibrillation.
- NT-proBNP also predicts prolonged hospitalization and heart-related readmissions.

## Abstract

N-terminal pro-brain natriuretic peptide (NT-proBNP) is a biomarker for heart
stress and heart failure, with its production triggered by the stretching of
cardiac fibers. This study investigates if elevated NT-proBNP levels can
independently predict poor outcomes for patients undergoing heart
surgery.

A systematic review was performed in the PubMed®, Latin American and
Caribbean Health Sciences Literature (or LILACS), Physiotherapy Evidence
Database (PEDro), Web of Science, and Embase databases, with the following
descriptors: "NT-proBNP" OR "NTproBNP" OR "N- terminal pro-B-type
natriuretic peptide" OR "N- terminal pro brain natriuretic peptide" OR
"amino terminal pro brain natriuretic peptide" AND "Cardiovascular Surgical
Procedures" NOT "Pediatric" OR "children" NOT "cancer" OR "oncology" NOT
"animal*". Articles that evaluated NT-proBNP and adverse outcomes in cardiac
surgical patients were chosen. The levels of evidence and the strength of
recommendation were assessed considering the Grading of Recommendations,
Assessment, Development and Evaluation (or GRADE) system and validity by the
PEDro scale. For systematic review, the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (or PRISMA) criteria and the
Population, Intervention, Comparison, Outcome (or PICO) strategy were
followed.

Forty-seven articles were included, of which 17 were related to serious
complications, including mortality.

Preoperative NT-proBNP is a prognostic marker for mortality, length of stay
in the postoperative intensive care unit, postoperative acute kidney injury,
postoperative atrial fibrillation, postoperative low cardiac output,
postoperative prolonged mechanical ventilation time, prolonged
hospitalization time, unscheduled hospital readmission related to heart
problems, and postoperative heart failure.