Article Sidebar

PDF
Date Published: 30/08/2025
Abstract Views: 5
Views PDF: 0
DOI: 10.47972/vjcts.v52i.1491
Issue
Vol. 52
Section
Research Article
How to Cite
Nguyen, T. T. H., Vu, H. P., & Vu, T. T. P. (2025). Evaluation of the prognostic role of plasma HS-TROPONIN T and NT-PROBNP levels in predicting major adverse events in patients undergoing coronary artery bypass graft surgery. The Vietnam Journal of Cardiovascular and Thoracic Surgery, 52, 53 - 61. https://doi.org/10.47972/vjcts.v52i.1491

Evaluation of the prognostic role of plasma HS-TROPONIN T and NT-PROBNP levels in predicting major adverse events in patients undergoing coronary artery bypass graft surgery

Thi Thanh Hang Nguyen1, , Hoang Phuong Vu2, Thi Thuc Phuong Vu
1 Hanoi Heart Hospital
2 Hanoi Medical University

Main Article Content

Abstract

Objective: To evaluate the prognostic value of post -operative plasma high-sensitivity troponin T (hs-TnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) for predicting major adverse events (MAEs) in patients undergoing coronary artery bypass grafting (CABG).


Methods: A prospective, cross-sectional, self-controlled study was conducted on patients undergoing isolated on-pump CABG at Hanoi Heart Hospital from August 2024 to February 2025. Clinical and biochemical parameters were collected preoperatively, intraoperatively, and postoperatively. MAEs recorded until hospital discharge included: prolonged inotropic/vasopressor support >48 hours, mechanical circulatory support (intra-aortic balloon pump [IABP] or extracorporeal membrane oxygenation [ECMO]), arrhythmias, stroke, renal replacement therapy, ICU stay ≥5 days, and in-hospital mortality or discharge in critical condition. Patients were classified into two groups based on the occurrence of MAEs. The predictive values of perioperative hs-TnT and NT-proBNP levels were analyzed.


Results: NT-proBNP levels on postoperative days 1 and 2 showed good predictive ability for overall MAEs, with areas under the ROC curve (AUC) of 0.702 (95% CI: 0.625–0.778; cut-off: 2827) and 0.732 (95% CI: 0.658–0.805; cut-off: 3187), respectively. hs-TnT levels immediately after surgery, and on postoperative days 1 and 2 demonstrated acceptable predictive value, with AUCs of 0.615 (95% CI: 0.531–0.699), 0.665 (95% CI: 0.584–0.746), and 0.644 (95% CI: 0.561–0.726), respectively. The two most frequent adverse events—prolonged inotropic/vasopressor use (>48 hours) and ICU stay ≥5 days—were best predicted by NT-proBNP on postoperative day 2, with AUCs of 0.810 (95% CI: 0.746–0.875) and 0.788 (95% CI: 0.702–0.875), respectively.


Conclusion: Postoperative NT-proBNP and hs-TnT levels are valuable biomarkers for early prediction of major perioperative complications in patients undergoing CABG.

Keywords

Coronary artery bypass graft surgery, NT-proBNP, high-sensitivity Troponin T (hs-Troponin T), postoperative complications

Article Details

References

1. M. S.G (2012). Circulating Forms Of The B-Type Natriuretic Peptide Prohormone: Pathophysiologic and Clinical Considerations, Elsevier Inc, Elsevier Inc.
2. Juncheng Wang (2023). Utility of Preoperative N – Terminal Pro – B – Type Natriuretic Peptide in the Prognosis of Coronary Artery Bypass Grafting. The American Journal of Cardilogy, 201, 131 – 138.
3. Giuseppe Crescenzi et al (2009). N- terminal B – natriuretic Peptide after coronary artery bypass graft surgery. J Cardiothorac Vasc Anesth, 2009 Apr.
4. Jessy A. Nellipudi et al (2021). Prognostic Value of High – Sensitivity Troponin T After On - Pump Coronary Artery Bypass Graft Surgery. Heart Lung and Circulation, Volume 30, Issue 10, 1562 – 1569.
5. Samuel Heuts et al (2022). Meta – Analysis Evaluating High – Sensitivity Cardiac Troponin T Kinetics after Coronary Artery Bypass Grafting in Relation to the Current Definitions of Myocardial Infarction. The American Journal of Cardiology, 163, 25 -31.