B-Type Natriuretic Peptide Levels Predict Outcomes in Coronary Artery Bypass Graft Patients

More than 250,000 patients undergo coronary artery bypass graft (CABG) surgery each year in the United States. New research in the April issue of Anesthesiology examines whether the hormone plasma B-type natriuretic peptide (BNP) helps indicate which patients are at risk of adverse cardiac events after CABG surgery.

BNP is secreted primarily by the muscle cells of the pumping chambers in the heart as a response to increased stress. Elevated levels of postoperative BNP during the first several days after CABG surgery is known to be associated with increased mortality. However, the current research analyzed whether BNP is also associated with poorer long-term physical function (ability to do chores, exercise, climb stairs and lie flat comfortably).

About the Study
The researchers administered a multi-purpose health survey (SF-36) to 845 eligible CABG surgery patients at Brigham and Women’s Hospital in Boston and the Texas Heart Institute in Houston both pre- and post-operatively. The questions focused on patients’ overall physical and emotional health including daily activities, exercise and pain levels.

The study found that increased levels of postoperative BNP was significantly associated with poor physical function six months to two years after CABG surgery. These findings are particularly important as many patients, especially seniors, often undergo CABG to not only prolong the length, but the quality of their lives.

“Since CABG patients with higher BNP levels are at an increased risk for both mortality and low physical function, it is important that these patients are considered for early and aggressive medical surveillance and treatment programs aimed at reducing BNP levels,” said lead study author Amanda Fox, M.D., M.P.H. Such programs would include the aggressive use of heart medicines as well as enrollment in cardiac rehabilitation programs.

Dr. Fox also added, “Future studies are needed to determine if such interventions and medical management would reduce elevated postoperative BNP and help improve the overall quality of life for CABG patients.”

For more information, visit the Anesthesiology website at www.anesthesiology.org.