The Role of Serial NT-ProBNP Level in Prognosis and Follow-Up Treatment of Acute Heart Failure after Coronary Artery Bypass Graft Surgery

Bui Duc Thanh; Nguyen Hong Son; Dinh Cong Pho; Nguyen Duy Bac; Vu Thi Nga; Quan Anh Dung; Do Duc Anh; Do Dieu Linh; Hoang Thi Bich Viet; Bui Dang The Anh; Ha The Tan; Pham Ngoc Hung

doi:10.3889/oamjms.2019.872

The Role of Serial NT-ProBNP Level in Prognosis and Follow-Up Treatment of Acute Heart Failure after Coronary Artery Bypass Graft Surgery

Open Access Maced J Med Sci. 2019 Dec 20;7(24):4411-4415. doi: 10.3889/oamjms.2019.872. eCollection 2019 Dec 30.

Authors

Bui Duc Thanh¹, Nguyen Hong Son², Dinh Cong Pho³, Nguyen Duy Bac⁴, Vu Thi Nga⁵, Quan Anh Dung³, Do Duc Anh⁶, Do Dieu Linh⁷, Hoang Thi Bich Viet⁸, Bui Dang The Anh⁹, Ha The Tan⁹, Pham Ngoc Hung^{4

9}

Affiliations

¹ Intensive Care Unit, 175 Military Hospital, Ho Chi Minh City, Vietnam.
² 175 Military Hospital, Ho Chi Minh City, Vietnam.
³ Faculty of Medicine, Vietnam Military Medical University, Hanoi, Vietnam.
⁴ Department of Training, Vietnam Military Medical University, Hanoi, Vietnam.
⁵ Institute for Research and Development, Duy Tan University, 03 Quang Trung, Danang, Vietnam.
⁶ Faculty of Medicine, University of Medical Sciences of Revolutionary Armed Force (UCIMED de Las FAR), Marianao, Havana, Cuba.
⁷ Faculty of Medicine, Hai Phong Medical University, 72A Nguyen Binh Khiem, Hai Phong, Vietnam.
⁸ Department of Occupational Lung Disease, National Lung Hospital, 463 Hoang Hoa Tham, Ba Dinh, Ha Noi, Vietnam.
⁹ Department of Epidemiology, Vietnam Military Medical University, Hanoi, Vietnam.

Abstract

Background: After coronary artery bypass graft (CABG) surgery, heart failure is still major problem. The valuable marker for it is needed.

Aim: Evaluating the role of serial NT-proBNP level in prognosis and follow-up treatment of acute heart failure after CABG surgery.

Methods: The prospective, analytic study evaluated 107 patients undergoing CABG surgery at Ho Chi Minh Heart Institute from October 2012 to June 2014. Collecting data was done at pre- and post-operative days with measuring NT-proBNP levels on the day before operation, 2 hours after surgery, every next 24 h until the 5^th day, and in case of acute heart failure occurred after surgery.

Results: On the first postoperative day (POD1), the NT-proBNP level demonstrated significant value for AHF with the cut-off point = 817.8 pg/mL and AUC = 0.806. On the second and third postoperative day, the AUC value of NT- was 0.753 and 0.751. It was statistically significant in acute heart failure group almost at POD 1 and POD 2 when analyzed by the doses of dobutamine, noradrenaline, and adrenaline (both low doses and normal doses).

Conclusion: Serial measurement of NT-proBNP level provides useful prognostic and follow-up treatment information in acute heart failure after CABG surgery.

Keywords: N-terminal pro-B-type natriuretic peptide (NT-proBNP); acute heart failure (AHF); coronary artery bypass graft surgery (CABG); follow-up treatment; prognosis; serial measurements.