Thorac Cardiovasc Surg 2012; 60 - PP52
DOI: 10.1055/s-0031-1297699

Brain natriuretic peptide (BNP) measurement during the first year after coronary artery bypass grafting

DH Bail 1, 2, G Ziemer 2, 3, T Walker 2
  • 1Universitätsspital Basel, Gefäßchirurgie und Organtransplantation, Basel, Switzerland
  • 2Universität Tübingen, Thorax-, Herz-und Gefäßchirurgie, Tübingen, Germany
  • 3University of Chicago Medical Center, Department of Surgery, Pediatric Cardiac Surgery and Adult Congenital Heart Surgery, Chicago, United States

Objective: Brain natriuretic peptide (BNP) is increased in patients with heart failure in proportion to the severity of left ventricular dysfunction. We investigated whether BNP could be used as a marker for the prediction of cardiac events after successful coronary artery bypass grafting (CABG).

Method: In this study, we prospectively examined plasma BNP levels of 33 pts. undergoing CABG. Plasma BNP measurements were carried out at 7 timepoints: preoperatively, 24 hours postoperatively, on the 6th postoperative day, 3, 6, 9 and 12 month postoperatively. At all timepoints, the NYHA class was documented and a concomitant transthoracic echocardiography (TEE) was performed.

Results: After a maximum peak 24 hours postoperatively plasma BNP decreased gradually during the first year after CABG. LVEF did not change over this period. Six (18%) of 33 pts. had recurring increasing BNP levels without or only with mild symptoms. After a further cardiological evaluation of these 6 patients required further therapeutic intervention (2 heart failure, 2 PTCA, 1 Re-CABG, 1 Arrhytmia). The mean NYHA class increased from 3.1 preoperatively to to 1.2 in pts. without cardiac events and to 1.9 in pts. with cardiac events.

Conclusion: Simultaneous measurement of plasma BNP and TEE are clinically useful for the prediction of ocurrence of cardiac events in patients after successful CABG. A recurrent increase in plasma BNP after CABG have to be carefully examined.