Predictive value of plasma brain natriuretic peptide for postoperative cardiac complications—A systemic review and meta-analysis

Background: Cardiac complications after a stroke are the second leading cause of death worldwide, affecting the treatment and outcomes of stroke patients. Cardiac biomarkers such as cardiac troponin (cTn), brain natriuretic peptide (BNP), and N-terminal pro-brain natriuretic peptide (NT-proBNP) have been frequently reported in patients undergoing a stroke. The aim of the present study is to meta-analyze the relationship between changes in such cardiac biomarkers and stroke and to present a systematic review of the previous literature, so as to explore the brain–heart axis. Methods: We searched four online databases pertinent to the literature, including PubMed, Embase, the Cochrane Library, and the Web of Science. Then, we performed a meta-analysis to investigate changes in cTn, BNP, and NT-proBNP associated with different types of stroke. Results and Conclusions: A significant increase in cTnI concentration was found in patients exhibiting a brain hemorrhage. BNP increased in cases of brain infarction, while the NT-proBNP concentration was significantly elevated in patients suffering an acute ischemic stroke and brain hemorrhage, indicating cardiac damage and dysfunction after a stroke. Our analysis suggests that several potential mechanisms may be involved in the brain–heart axis. Finally, clinicians should pay careful attention to monitoring cardiac function in the treatment of cerebrovascular diseases in order to provide a timely and more accurate treatment.

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The prognostic value of N-terminal pro-brain natriuretic peptide in non-ST elevation acute coronary syndromes: a meta-analysis

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm.2011.824 ◽

2012 ◽

Vol 50 (4) ◽

Cited By ~ 6

Author(s):

Xiaocong Zeng ◽

Lang Li ◽

Qiang Su

Keyword(s):

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Predictive Value ◽

Acute Coronary Syndromes ◽

Meta Analysis ◽

Predictive Values ◽

Relative Risks ◽

Increased Risk ◽

Coronary Syndromes ◽

St Elevation

AbstractPrecise risk stratification is important in patients with non-ST elevation acute coronary syndromes (NSTE-ACS) on determination for hospitalization and intensity of treatment. A meta-analysis was performed in studies of patients with NSTE-ACS to evaluate the predictive nature of elevated N-terminal pro-brain natriuretic peptide (NT-proBNP).Online searches were conducted using database to identify suitable studies. A summary of relative risks (RRs) for death and myocardial infarction (MI) was calculated using random-effects modeling. We also calculated the pooled sensitivity, specificity, positive predictive value, and negative predictive value.Thirteen studies were included. Elevated NT-proBNP levels were significantly associated with mortality [RR 4.89; 95% confidence interval (CI) 3.85–6.22] and incidence of MI (RR 1.66; 95% CI 1.24–2.22). The sensitivity and specificity for MI was 69.1% (95% CI 66.6%–71.6%) and 43.6% (95% CI 42.9%–44.3%), respectively, along with the positive and negative predictive values for MI of 8.2% (95% CI 7.7%–8.7%) and 95.1% (95% CI 94.6%–95.5%), respectively.Meta-analysis suggests that elevated NT-proBNP levels were associated with an increased risk for MI or death in patients with NSTE-ACS. Normal levels of NT-proBNP are certainly more helpful when selecting NSTE-ACS patients with likelihood for favorable outcomes.

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Predictive Value of Plasma Brain Natriuretic Peptide Levels in Left Atrial Spontaneous Echo Contrast in Patients with Atrial Fibrillation

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2014.07.206 ◽

2014 ◽

Vol 20 (10) ◽

pp. S167

Author(s):

Kyoung-Im Cho ◽

Tae-Joon Cha ◽

Jung-Ho Heo ◽

Hyun-Su Kim ◽

Jae-Woo Lee

Keyword(s):

Atrial Fibrillation ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Predictive Value ◽

Left Atrial ◽

Spontaneous Echo Contrast ◽

Plasma Brain Natriuretic Peptide

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Predictive value of plasma brain natriuretic peptide for cardiac outcome after vascular surgery

Heart ◽

10.1136/hrt.2005.060988 ◽

2005 ◽

Vol 92 (3) ◽

pp. 401-402 ◽

Cited By ~ 25

Author(s):

C Berry

Keyword(s):

Vascular Surgery ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Predictive Value ◽

Plasma Brain Natriuretic Peptide ◽

Cardiac Outcome

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TCT-819 Effect of Transfemoral Aortic Valve Implantation on Plasma Brain Natriuretic Peptide Levels and Its Predictive Value for 30-day and 1-year survival

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2012.08.865 ◽

2012 ◽

Vol 60 (17) ◽

pp. B238

Author(s):

Karim El Chilali ◽

Thomas Konorza ◽

Fadi Al-Rashid ◽

Polykarpos Patsalis ◽

Bjoern Plicht ◽

...

Keyword(s):

Aortic Valve ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Predictive Value ◽

Plasma Brain Natriuretic Peptide ◽

Aortic Valve Implantation ◽

Valve Implantation

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Brain natriuretic peptide to predict successful liberation from mechanical ventilation in critically ill patients: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-022600 ◽

2019 ◽

Vol 9 (2) ◽

pp. e022600

Author(s):

Jean Deschamps ◽

Jordan Webber ◽

Robin Featherstone ◽

Meghan Sebastianski ◽

Ben Vandermeer ◽

...

Keyword(s):

Systematic Review ◽

Mechanical Ventilation ◽

Statistical Analysis ◽

Brain Natriuretic Peptide ◽

Critically Ill ◽

Natriuretic Peptide ◽

Critically Ill Patients ◽

Predictive Value ◽

Meta Analysis ◽

Current Evidence

IntroductionPredicting successful liberation from mechanical ventilation (MV) among critically ill patients receiving MV can be challenging. The current parameters used to predict successful extubation have shown variable predictive value. Brain natriuretic peptide (BNP) has been proposed as a novel biomarker to help guide decision-making in readiness for liberation of MV following a spontaneous breathing trial (SBT). Current evidence on the predictive ability of BNP has been uncertain, and BNP has not been integrated into clinical practice guidelines.Methods and analysisWe will perform a systematic review and meta-analysis to evaluate the value of BNP during SBT to predict success of liberation from MV. A search strategy will be developed in collaboration with a research librarian, and electronic databases (MEDLINE, EMBASE, Cochrane Library, Web of Science) and additional sources will be searched. Search themes will include: (1) BNP and (2) weaning, extubation and/or liberation from MV. Citation screening, selection, quality assessment and data abstraction will be performed in duplicate. The primary outcome will be liberation from MV; secondary outcomes will include time to reintubation, mortality, MV duration, total and postextubation intensive care unit (ICU) stay, hospitalisation duration, tracheostomy rate, ICU-acquired weakness rate and ventilator-free days. Primary statistical analysis will include predictive value of BNP by receiver operating characteristic curve, sensitivity/specificity and likelihood ratios for combination of BNP and SBT parameters for failure of liberation from MV. Secondary statistical analysis will be performed on individual and combinations of extracted metrics.Ethics and disseminationOur review will add knowledge by mapping the current body of evidence on the value of BNP testing for prediction of successful liberation from MV, and describe knowledge gaps and research priorities. Our findings will be disseminated through peer-reviewed publication, presentation at a scientific congress, through regional/national organisations and social media. Research ethics approval is not required.PROSPERO registration numberCRD42018087474.

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