Serum B-type Natriuretic Peptide Levels for the Prediction of Death in Post-Cardiac Arrest Patients Treated with Therapeutic Hypothermia.
- Author:
Hyun Chul AN
1
;
Yong Su LIM
;
Jin Seong CHO
;
Jin Joo KIM
;
Hyuk Jun YANG
;
Won Bin PARK
;
Jae Hyug WOO
;
Sung Youl HYUN
Author Information
1. Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon, Korea. yongem@gilhospital.com
- Publication Type:Original Article
- Keywords:
Heart arrest;
Cardiopulmonary resuscitation;
Brain natriuretic peptide;
Induced hypothermia
- MeSH:
APACHE;
Cardiopulmonary Resuscitation;
Death, Sudden, Cardiac;
Heart Arrest;
Heart Failure;
Humans;
Hypothermia*;
Hypothermia, Induced;
Logistic Models;
Male;
Natriuretic Peptide, Brain*;
Out-of-Hospital Cardiac Arrest;
Sensitivity and Specificity;
Survivors
- From:Journal of the Korean Society of Emergency Medicine
2013;24(5):508-515
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Studies have demonstrated that B-type natriuretic peptide (BNP) has a predictive value for sudden cardiac arrest in heart failure patients. The aim of this study was to investigate the usefulness of serum BNP levels for theprediction of death in post-cardiac arrest patients treated with-therapeutic hypothermia (TH). METHODS: Out-of-hospital cardiac arrest (OHCA) survivors treated with TH between April 2007 and August 2010 were evaluated and divided into two groups based on death within 3 months. Initial serum BNP levels were checked and BNP levels compared between both groups. RESULTS: A total of 162 patients were enrolled in the study. Among 162 patients, 109 patients were male (mean age of 50 years). The BNP levels of the non-survival group (n=77) were higher than those of the survival group (n=85); however, there was no statistical difference (19.45 pg/ml vs. 30.75 pg/ml, p=0.174). The BNP cutoff value of 106 pg/ml for death within 3 months had a sensitivity of 35.1% and a specificity of 78.8%. In the logistic regression analysis, BNP levels higher than 106 pg/ml were significantly associated with death within 3 months (odds ratio [OR], 2.625; 95% confidence interval [CI], 1.066-6.463) and other independent factors were BLS to ROSC (OR, 1.105; CI, 0.082-1.038), non-VF/VT (OR, 3.698; CI, 1.632-8.380), and APACHE II score (OR, 1.117; CI, 1.035-1.204). CONCLUSION: Initial Serum BNP levels are related with death within 3 months for patients that received TH after OHCA. However, additional randomized and controlled studies are needed.