Open AccessPreoperative NT‐proBNP Predicts Midterm Outcome After Septal Myectomy
Author(s) -
Song Changpeng,
Wang Shengwei,
Guo Ying,
Zheng Xinxin,
Lu Jie,
Fang Xiaonan,
Wang Shuiyun,
Huang Xiaohong
Publication year - 2019
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.118.011075
Subject(s) - medicine , hazard ratio , interquartile range , cardiology , proportional hazards model , septal myectomy , brain natriuretic peptide , natriuretic peptide , coronary artery disease , heart failure , hypertrophic cardiomyopathy , surgery , confidence interval , obstructive cardiomyopathy
Background The prognostic value of N‐terminal pro–brain natriuretic peptide ( NT ‐pro BNP ) in patients with hypertrophic cardiomyopathy who underwent septal myectomy has not been well studied. Methods and Results We retrospectively evaluated NT ‐pro BNP levels in 758 patients (46.1±13.8 years; median follow‐up, 936 days) who underwent septal myectomy in our center between March 2011 and April 2018. The median NT ‐pro BNP level was 1450.5 (interquartile range 682.6‐2649.5) pg/mL. Overall, 22 (2.9%) patients died during follow‐up; of these, 86.4% were cardiovascular deaths. The 3‐year survival free from all‐cause mortality by tertile was 95.2% (95% CI 91.1% to 97.4%; NT ‐pro BNP >2080 pg/mL), 98.3% (95% CI 94.6% to 99.5%; NT ‐pro BNP , 947‐2080 pg/mL), and 99.2% (95% CI , 94.4% to 99.9%; NT ‐pro BNP <947 pg/mL). The 3‐year survival rate free from cardiovascular mortality by tertiles was 95.2% in the highest tertile, 98.8% in the middle tertile, and 99.2% in the lowest tertile. Cox regression analysis indicated that Ln( NT ‐pro BNP ) was a significantly independent predictor of all‐cause mortality (hazard ratio 2.380, 95% CI 1.356‐4.178, P =0.003) and cardiovascular mortality (hazard ratio 2.788, 95% CI 1.450‐5.362, P =0.002). In addition, concomitant coronary artery bypass grafting for coronary artery disease was also an independent predictor of cardiovascular mortality (hazard ratio 5.178, 95% CI 1.597‐16.789, P =0.006). Conclusions Increased preoperative NT ‐pro BNP level is a strong predictor of midterm mortality in patients undergoing septal myectomy.