Association of pre-operative N-terminal pro–B-type natriuretic peptide level on early outcomes of off-pump coronary artery bypass grafting

Mohammad M.  Haque; Manjurul Hasan; M. Faysal Ahmed; Sirajum Munira; Samsun Nahar; Syeda Najiba Hossain

doi:10.18203/2349-2902.isj20253006

Authors

Mohammad M. Haque Department of Surgery, Director General Health Services, Mohakhali, Dhaka, Bangladesh
Manjurul Hasan Department of Vascular Surgery, Dhaka Medical College, Dhaka, Bangladesh
M. Faysal Ahmed Director General Health Services, Mohakhali, Dhaka, Bangladesh
Sirajum Munira National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh
Samsun Nahar Department of Biochemistry, Bashundhara Ad-din Medical College and Hospital, Dhaka, Bangladesh
Syeda Najiba Hossain Director General Health Services, Mohakhali, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2349-2902.isj20253006

Keywords:

Pre-operative, NT- Pro-BNP, Early outcomes, CABG

Abstract

Background: Off-pump coronary artery bypass grafting (OPCABG) is considered safer than traditional on-pump coronary artery bypass grafting (CABG) due to its avoidance of a heart-lung machine. This study was aimed to evaluate role of pre-operative N-terminal pro–B-type natriuretic peptide (NT-pro-BNP) level in patients undergoing OPCABG.

Methods: A comparative cross-sectional study was carried out in the Department of Cardiac Surgery, National Institute of Cardiovascular Diseases (NICVD) from January 2022 to December 2023. Continuous data were analyzed by Student’s t-test and categorical data by Chi-square and Fisher’s exact test. A p≤0.05 was considered statistically significant.

Results: Our study shows that the incidence of arrhythmia was significantly higher in group A (NT-pro-BNP≥348 pg/ml) than group B (NT-pro-BNP<348 pg/ml). Post-operative arrhythmia occurred only in 9 (18%) patients in group B but in group A 19 (38%) patients developed arrhythmia (p<0.001). Incidence of postoperative low cardiac output syndrome (LCOS) was significantly higher in group A (NT-pro-BNP≥348 pg/ml). Group A patients experienced notably extended mechanical ventilation time (9.77±4.87 versus 6.39±2.13 hours; p<0.001), prolonged ICU stay (7.01±5.12 versus 4.87±2.98 days; p=0.005), and extended postoperative hospital stay (12.56±5.40 versus 7.08±4.15 days; p<0.001) compared to group B. No significant difference was observed between the two groups in regards to demographics and associated risk factors.

Conclusion: Our current study illustrated that elevated preoperative NT-pro-BNP levels (≥348) were linked to an increased occurrence of postoperative complications such as low cardiac output syndrome and arrhythmia.

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