Prognostic value of a combination of cardiac biomarkers and risk indices for major adverse cardiovascular events following non-cardiac surgery in geriatric patients: a prospective cohort study

Major adverse cardiovascular events (MACEs) in geriatric patients are an important cause of increased mortality and morbidity. The results of current studies regarding the predictive value of the NT-proBNP, H-FABP, and AUB-HAS2 scales for cardiovascular complications are inconsistent, and there is no relevant large sample study. Therefore, this study aimed to investigate whether preoperative NT-proBNP, H-FABP, and AUB-HAS2 alone or in combination can effectively predict postoperative cardiovascular complications in geriatric patients. A total of 1736 geriatric patients (aged ≥ 65 years) who were scheduled for elective non-cardiac surgery under general anesthesia were enrolled. AUB-HAS2 risk assessment is required for each patient, and blood was collected 1 h before surgery for the measurement of NT-proBNP and H-FABP. The primary outcomes were MACEs within 30 days after surgery. The secondary outcomes were other complications. Its predictive value was analyzed by receiver operating characteristic (ROC) curves. Of the 1736 patients, 71 (4.1%) had MACEs. NT-proBNP was a predictor of MACEs (AUC = 0.763; 95% CI 0.695-0.832; P < 0.001). When H-FABP was combined with AUB-HAS2, AUB-HAS2 increased the predictive value of H-FABP (AUC = 0.736; 95% CI 0.673-0.799; P < 0.001). Multiple logistic regression analysis revealed increased predictive value of the modified AUB-HAS2 scale for MACEs (AUC = 0.794, 95% CI = 0.737-0.851, P < 0.001). Our study revealed the predictive efficacy and prognostic value of NT-proBNP, H-FABP and the AUB-HAS2 score alone or in combination for postoperative MACE risk assessment in geriatric patients undergoing non-cardiac surgery.This trial was registered at the Chinese Clinical Trial Registry (2019/09/27 ChiCTR1900026223, https://www.chictr.org.cn ).