Preoperative Cardiac Biomarkers as Predictors of Acute Kidney Injury and Arrhythmias After CABG

Abstract

Purpose: Postoperative complications such as acute kidney injury (AKI) and atrial fibrillation (AF) remain major concerns following coronary artery bypass grafting (CABG). This review explores the predictive role of preoperative cardiac biomarkers—NT-proBNP, high-sensitivity Troponin I (hs-TnI), and creatine kinase-MB (CK-MB)—in identifying patients at risk for these complications.

Design/Methodology: A structured literature review was conducted focusing on studies and meta-analyses published within the last five years that assessed the association between preoperative biomarker levels and the incidence of AKI and postoperative atrial fibrillation (POAF) in CABG patients.

Findings: NT-proBNP consistently demonstrated strong predictive value for both AKI and POAF. Elevated preoperative NT-proBNP levels were associated with higher postoperative complication rates, especially in patients with underlying cardiac dysfunction. In contrast, hs-TnI and CK-MB showed less consistent and weaker predictive power.

Conclusion: NT-proBNP is a reliable biomarker for perioperative risk stratification, while the utility of hs-TnI and CK-MB remains limited. Incorporating NT-proBNP measurement into preoperative assessments could enhance individualized risk prediction, guide prophylactic strategies, and improve clinical outcomes in CABG patients