Biomarkers improve risk models for heart surgery patients

Secretoneurin and NT-proBNP should be included in the risk assessment of patients being evaluated for cardiac surgery, according to Jon Brynildsen‘s PhD thesis.


  1. Measuring NT-proBNP or secretoneurin could improve risk prediction in cardiac surgical patients.
  2. A simple model of NT-proBNP and three easily available clinical risk factors is probably at least as good as EUROSCORE II in predicting long-term outcome after heart surgery.
  3. Secretoneurin also improves risk prediction in aortic stenosis.


Thesis: A search for novel treatments against ventricular arrhythmias
Candidate: Jon Brynildsen
Time: June 25, 2020 at 11:15
Place: Online-based solution, due to the covid-19 situation
Link to university website


(1/2) N-terminal pro-B-type natriuretic peptide, (NT-proBNP), secretoneurin and high-sensitivity troponin T (hs-TnT) levels measured pre- and post-operatively are lower in patients that are still alive 2-3 years after cardiac surgery, compared to non-survivors. Moreover, NT-proBNP and postoperative secretoneurin improves risk stratification when added to the commonly used EUROSCORE II model. Including age, creatinine clearance, COPD and NT-proBNP in a single model predicted prognosis comparatively well to EUROSCORE II.

The studies include pre- and postoperative samples from more than 600 cardiac surgical patients. The median follow-up time was 961 days, by which 10% of the patients had died. The predictive ability of NT-proBNP were also confirmed in a cohort of 90 patients with respiratory failure after cardiac surgery.

(3) Secretoneurin adds prognostic information on top of established risk models in patients with moderate to severe aortic stenosis. The study includes 57 patients, of which 15 died during a median of 3.5 years follow-up. Non-survivors had higher levels of secretoneurin, and the association remained after adjustment for established risk indices, biomarkers and surgical status.


(1) Brynildsen, J., Petäjä, L., Pettilä, V., Nygård, S., Vaara, S. T., Linko, R., Okkonen, M., Hagve, T.-A., Soininen, L., Suojaranta-Ylinen, R, Lyngbakken, M. N., Omland, T., & Lyngbakken, M. N. (2018). The predictive value of NT-proBNP and hs-TnT for risk of death in cardiac surgical patientsClinical biochemistry53, 65-71.

(2) Brynildsen, J., Petäjä, L., Myhre, P. L., Lyngbakken, M. N., Nygård, S., Stridsberg, M., Christensen, G., Ottesen, A., Pettilä, V., Omland, T., & Røsjø, H. (2019). Circulating Secretoneurin Concentrations After Cardiac Surgery: Data From the FINNish Acute Kidney Injury Heart StudyCritical care medicine47(5), e412-e419.

(3) Brynildsen, J., Myhre, P. L., Lyngbakken, M. N., Klaeboe, L. G., Stridsberg, M., Christensen, G., Edvardsen, T., Omland, T., & Røsjø, H. (2019). Circulating secretoneurin concentrations in patients with moderate to severe aortic stenosis. Clinical biochemistry71, 17-23.

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