ORIGINAL ARTICLE
Year : 2021  |  Volume : 8  |  Issue : 6  |  Page : 114-119

Role of Cardio-biomarkers (NT-Pro BNP and Troponin I) in cardiac risk stratification of patients undergoing major vascular surgeries


Department of Vascular Surgery, Army Hospital R&R, New Delhi, India

Correspondence Address:
Vikram Patra
Department of Vascular Surgery, Army Hospital R&R, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijves.ijves_144_20

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Objective: The objective is to assess the role of cardio-biomarkers, namely, N-Terminal Pro-hormone Beta Natriuretic Peptide (NT-ProBNP) and Cardiac Troponin I (cTnI) in prediction of postoperative cardiac events (POCEs) in noncardiac patients undergoing major vascular surgery and compare their efficacy with Revised Cardiac Risk Indices (RCRI) in preoperative period. Materials and Methods: Quantitative analysis of cTnI and NT-ProBNP was done in pre- and post-operative period in patients, who underwent elective major vascular surgeries between April 2018 and April 2020 at a tertiary care hospital. The ability of both the cardio-biomarkers, either alone or in combination were assessed for the prediction of POCE and results were compared with RCRI in preoperative period. The relationship between postoperative quantitative values of both the biomarkers and development of POCE were also analyzed. Results: A total of 170 patients were enrolled and the incidence of POCE was observed in 15.9% (27) of our patients. The “cut-off” values of cTnI, and NT-ProBNP in preoperative period were found to be 0.011 μg/L and 335 pg/mL and in postoperative period were 0.024 μg/L and 438 pg/mL, respectively. In preoperative period, biomarkers, either alone or in combination, outperformed RCRI in prediction of POCE and when individual biomarker was assessed, NT-ProBNP had better efficacy than cTnI. In postoperative period, predictive ability of both the biomarkers were similar, however, combination of both significantly improved the prediction of POCE as represented by increase in area under the curve, sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy. Conclusion: As compared to RCRI, cardio-biomarkers were better predictor of POCE in preoperative period and their efficacy in forecasting POCE continued even in postoperative period.


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