Evidence map›Paper›PMID 40865190›Full record

ArticleJACC. Advances2025

Prognostic Implications of Preoperative N-Terminal Pro-B-Type Natriuretic Peptide Dynamics in Patients Undergoing Cardiac Surgery.

Leo Pölzl, Ronja Lohmann, Fabian Theurl, Christian Puelacher, Philipp Sterzinger, Jonas Eder, Christian Sutter, Maria Ioannou-Nikolaidou, Felix Nägele, Jakob Hirsch and 18 more

Abstract read
In one paragraph

Article in JACC. Advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

28 authors.

Leo PölzlDepartment of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Ronja LohmannDepartment of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Fabian TheurlUniversity Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Innsbruck, Austria.
Christian PuelacherUniversity Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Innsbruck, Austria.
Philipp SterzingerDepartment of Statistics, University of Warwick, Coventry, United Kingdom.
Jonas EderDepartment of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Christian SutterDepartment of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Maria Ioannou-NikolaidouDepartment of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Felix NägeleDepartment of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Jakob HirschDepartment of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Michael GraberDepartment of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Clemens EnglerDepartment of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Vanessa HeimDepartment of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Sophia SchmidtDepartment of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Juliane KiloDepartment of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Sebastian J ReinstadlerUniversity Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Innsbruck, Austria.
Hanno UlmerDepartment for Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Innsbruck, Austria.
Samuel HeutsCardio-Thoracic Surgery Department, Maastricht University Medical Centre, Maastricht, the Netherlands.
Tomas GudbjartssonDepartment of Cardiothoracic Surgery, Landspitali University Hospital, Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
Anders JeppssonDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Emely ÖgrenDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Andrea GriesmacherCentral Institute of Clinical Chemistry and Laboratory Medicine, Medical University of Innsbruck, Innsbruck, Austria.
Michael GrimmDepartment of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Axel BauerUniversity Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Innsbruck, Austria.
Nikolaos BonarosDepartment of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Gerhard PölzlUniversity Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Innsbruck, Austria.
Johannes HolfeldDepartment of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria; Department of Cardiovascular Surgery, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, Munich, Germany.
Can Gollmann-TepeköylüDepartment of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria. Electronic address: can.gt@i-med.ac.at.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHigh levels of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) reflect poor cardiac status in heart failure patients.

objectivesThis study analyzed the association of preoperative NT-proBNP dynamics with 30-day and 5-year mortality after cardiac surgery.

methodsA consecutive cohort of 6,938 patients undergoing cardiac surgery was analyzed. The relationship between preoperative NT-proBNP levels and 30-day and 5-year mortality (median follow up time: 4.53 [2.00-5.00] years) adjusted for EuroSCORE II was explored with a Cox proportional hazards model. The dynamics of preoperative NT-proBNP levels were analyzed by comparing the values at diagnosis or assignment to surgery with the values on the day before surgery (n = 4,739). Results were validated in an external cohort from the SWEDEHEART registry (n = 3,117).

resultsMedian preoperative NT-proBNP concentration was 552 (208-1,591) ng/L. Death within 30 days occurred in 2.1% (149/6,938) of the population. High preoperative NT-proBNP levels were associated with higher 30-day and 5-year mortality. Initial high NT-proBNP at diagnosis, with subsequent decrease in preoperative NT-proBNP below 3,000 ng/L, was associated with more favorable perioperative outcomes after adjustment for EuroSCORE II shorter stays in intensive care unit (OR: 0.60, 95% CI: 0.44-0.82), less use of ultrafiltration (OR: 0.48, 95% CI: 0.33-0.70), or extracorporeal membrane oxygenation (OR: 0.26, 95% CI: 0.12-0.57; all P < 0.001) and lower 30-day mortality (HR: 0.21, 95% CI: 0.07-0.61; P = 0.004). Five-year survival was improved in patients with decreases in preoperative NT-proBNP levels (log-rank: P < 0.001, HR: 0.44, 95% CI: 0.30-0.65).

conclusionsReductions in NT-proBNP levels before surgery were associated with lower 30-day and 5-year mortality after cardiac surgery. Patients with high NT-proBNP concentrations may benefit from preoperative optimization to lower NT-proBNP.

Indexed as

cardiac surgeryNT-proBNPperioperative risk assessment

Identifiers

PMID40865190
PMCPMC12409294

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