--- title: "Preoperative NT-proBNP and Cardiovascular Events After…" description: "Measuring preoperative NT-proBNP levels can significantly improve the prediction of cardiovascular complications and death after noncardiac surgery." url: "https://magellanlongevity.com/study/d31869834.md" canonical: "https://magellanlongevity.com/study/d31869834.html" html: "https://magellanlongevity.com/study/d31869834.html" type: "study" study_key: "d31869834" journal: "Ann Intern Med" year: 2019 pmid: "31869834" doi: "10.7326/M19-2501" citations: 1 updated: 2026-09-02 author: "Gabriel Radu, DO" author_credentials: "Physiatrist (PM&R). NY medical license 275110. NPI 1376861765." publisher: "Magellan Longevity" content_format: "markdown" --- # Preoperative NT-proBNP and Cardiovascular Events After Noncardiac Surgery: A Cohort Study [Home](https://magellanlongevity.com/) › [Research map](https://magellanlongevity.com/longevity-research-map.html) › Preoperative NT-proBNP and Cardiovascular Events After… **HTML version:** https://magellanlongevity.com/study/d31869834.html · **In the Magellan app:** https://magellanlongevity.com/#/study/d31869834 ## Citation | Field | Value | | --- | --- | | Journal | Ann Intern Med | | Year | 2019 | | PMID | [31869834](https://pubmed.ncbi.nlm.nih.gov/31869834/) | | DOI | [10.7326/M19-2501](https://doi.org/10.7326/M19-2501) | | Study key | d31869834 | ## Takeaway Measuring preoperative NT-proBNP levels can significantly improve the prediction of cardiovascular complications and death after noncardiac surgery. ## The question Does preoperative N-terminal pro-B-type natriuretic peptide (NT-proBNP) provide additional predictive value beyond a clinical risk score for vascular death and myocardial injury after noncardiac surgery (MINS) within 30 days? ## Hypothesis Preoperative NT-proBNP may improve risk prediction in patients undergoing noncardiac surgery. ## Methods This was a prospective cohort study involving 10,402 patients aged 45 years or older undergoing inpatient noncardiac surgery across 16 hospitals in 9 countries. All patients had NT-proBNP levels measured before surgery and troponin T levels measured daily for up to 3 days after surgery. ## Results Compared with NT-proBNP values less than 100 pg/mL, higher levels were associated with increased adjusted hazard ratios for the primary outcome (vascular death and MINS). Specifically, levels of 100 to less than 200 pg/mL had an HR of 2.27, 200 to less than 1500 pg/mL had an HR of 3.63, and 1500 pg/mL or greater had an HR of 5.82. The incidences of the primary outcome for these groups were 12.3%, 20.8%, and 37.5%, respectively. Adding NT-proBNP thresholds to clinical stratification (Revised Cardiac Risk Index) resulted in a net absolute reclassification improvement of 258 per 1000 patients. Preoperative NT-proBNP values were also significantly associated with 30-day all-cause mortality, with incidences of 0.3% for less than 100 pg/mL, 0.7% for 100 to less than 200 pg/mL, 1.4% for 200 to less than 1500 pg/mL, and 4.0% for 1500 pg/mL or greater. ## Conclusion Preoperative NT-proBNP is strongly associated with vascular death and MINS within 30 days after noncardiac surgery and improves cardiac risk prediction beyond the Revised Cardiac Risk Index. ## Limitations External validation of the identified NT-proBNP thresholds in other cohorts would reinforce these findings. ## Verbatim from the abstract > Preoperative NT-proBNP is strongly associated with vascular death and myocardial injury ## Incidence of Vascular Death and MINS by Preoperative NT-proBNP Levels | Measure | Incidence (%) | | --- | --- | | <100 pg/mL | 0 | | 100 to <200 pg/mL | 12.3 | | 200 to <1500 pg/mL | 20.8 | | >=1500 pg/mL | 37.5 | *The incidence of vascular death and myocardial injury after noncardiac surgery (MINS) within 30 days increases with higher preoperative NT-proBNP levels.* ## Where this study is used on Magellan This paper is one of the citations behind the evidence grade on the pages below. Grades are assigned from the published research and are independent of affiliate commissions. | Compound or device | Evidence grade | Graded pages | | --- | --- | --- | | NT-proBNP Cardiac Test | — | — | ## Reference 1. **Preoperative NT-proBNP and Cardiovascular Events After Noncardiac Surgery: A Cohort Study** Ann Intern Med 2019 · [PMID 31869834](https://pubmed.ncbi.nlm.nih.gov/31869834/) · [DOI 10.7326/M19-2501](https://doi.org/10.7326/M19-2501) > Preoperative NT-proBNP is strongly associated with vascular death and myocardial injury ## Structured data ```json {"@context":"https://schema.org","@graph":[{"@type":"MedicalWebPage","@id":"https://magellanlongevity.com/study/d31869834.html#page","url":"https://magellanlongevity.com/study/d31869834.html","name":"Preoperative NT-proBNP and Cardiovascular Events After Noncardiac Surgery: A Cohort Study","description":"Measuring preoperative NT-proBNP levels can significantly improve the prediction of cardiovascular complications and death after noncardiac surgery.","inLanguage":"en","isPartOf":{"@type":"WebSite","name":"Magellan Longevity","url":"https://magellanlongevity.com/"},"author":{"@type":"Person","name":"Gabriel Radu, DO","jobTitle":"Physiatrist (PM&R)","identifier":[{"@type":"PropertyValue","name":"NPI","value":"1376861765"},{"@type":"PropertyValue","name":"NY medical license","value":"275110"}]},"publisher":{"@type":"Organization","name":"Magellan Longevity","url":"https://magellanlongevity.com/"},"encoding":{"@type":"MediaObject","encodingFormat":"text/markdown","contentUrl":"https://magellanlongevity.com/study/d31869834.md"},"dateModified":"2026-09-02"},{"@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://magellanlongevity.com/"},{"@type":"ListItem","position":2,"name":"Research map","item":"https://magellanlongevity.com/longevity-research-map.html"},{"@type":"ListItem","position":3,"name":"Preoperative NT-proBNP and Cardiovascular Events After…","item":"https://magellanlongevity.com/study/d31869834.html"}]},{"@type":"ScholarlyArticle","@id":"https://magellanlongevity.com/study/d31869834.html#study","name":"Preoperative NT-proBNP and Cardiovascular Events After Noncardiac Surgery: A Cohort Study","headline":"Preoperative NT-proBNP and Cardiovascular Events After Noncardiac Surgery: A Cohort Study","datePublished":"2019","isPartOf":{"@type":"Periodical","name":"Ann Intern Med"},"identifier":"PMID:31869834","url":"https://pubmed.ncbi.nlm.nih.gov/31869834/","sameAs":"https://doi.org/10.7326/M19-2501","abstract":"Measuring preoperative NT-proBNP levels can significantly improve the prediction of cardiovascular complications and death after noncardiac surgery."}]} ``` ## Related on Magellan Longevity - [Evidence: NT-proBNP natriuretic peptide](https://magellanlongevity.com/study/s158.md) - [NT-proBNP and mortality across the spectrum of glucose tolerance in the general US…](https://magellanlongevity.com/study/d36344968.md) - [Longevity research map](https://magellanlongevity.com/longevity-research-map.html) - [Evidence-based longevity supplements](https://magellanlongevity.com/longevity-supplements.md) ## Scope and disclosures Educational information, not medical advice. Nothing here is intended to diagnose, treat, cure, or prevent any disease. Talk to your physician before starting any supplement or device, especially if you are pregnant, nursing, or taking medication. Editorial firewall: evidence grades are assigned from the published research and are independent of any affiliate commission. As an Amazon Associate, Magellan Longevity earns from qualifying purchases. Reviewed for accuracy by a board-certified physician (DO).