NT-proBNP in patients with out-of-hospital cardiac arrest: Results from the FINNRESUSCI Study

Myhre, Peder L.; Tiainen, Marjaana; Pettilä, Ville; Vaahersalo, Jukka; Hagve, Tor‐Arne; Kurola, Jouni; Varpula, Tero; Omland, Torbjørn; Røsjø, Helge

doi:10.1016/j.resuscitation.2016.04.007

Cited by 17 publications

(19 citation statements)

References 37 publications

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“…Adjusting for demographic-and clinical variables, the prognostic value of NT-proBNP was attenuated and no longer statistically signi cant. These ndings are consistent with two previous studies [24,25], reporting a similar association between admission levels of NT-proBNP and outcome in resuscitated OHCA patients. There are several possible mechanisms for increased NT-proBNP/BNP secretion during cardiac arrest and CPR, including hypoxemia [30], ischemia [31], ischemia-reperfusion induced in ammation [32], therapeutic interventions with administration of uids [33] and vasopressors [34], and mechanical ventilation with supplementary oxygen administration [35].…”

Section: Discussionsupporting

confidence: 93%

“…There are several possible mechanisms for increased NT-proBNP/BNP secretion during cardiac arrest and CPR, including hypoxemia [30], ischemia [31], ischemia-reperfusion induced in ammation [32], therapeutic interventions with administration of uids [33] and vasopressors [34], and mechanical ventilation with supplementary oxygen administration [35]. Myhre et al 2016 [24] demonstrated an increase in NT-proBNP levels from admission up to 96 hours after hospitalization in OHCA-VT/VF patients. Longer time to ROSC and higher admission levels of hs-cTnT were found to be associated with high NT-proBNP concentrations after 24 hours in multivariable analysis.…”

Section: Discussionmentioning

confidence: 99%

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N-Terminal Pro-B-Type Natriuretic Peptide as a Prognostic Indicator for 30-Day Mortality Following Out-of-Hospital Cardiac Arrest: A prospective observational study.

Aarsetøy¹,

Omland

Røsjø

et al. 2020

Preprint

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Background: Early risk stratification applying cardiac biomarkers may prove useful in sudden cardiac arrest patients. We investigated the prognostic utility of early-on levels of high sensitivity cardiac troponin-T (hs-cTnT), copeptin and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with out-of-hospital cardiac arrest (OHCA).Methods: We conducted a prospective observational unicenter study, including patients with OHCA of assumed cardiac origin from the southwestern part of Norway from 2007 until 2010. Blood samples for later measurements were drawn during cardiopulmonary resuscitation or at hospital admission.Results: A total of 114 patients were included, 37 patients with asystole and 77 patients with VF as first recorded heart rhythm. Forty-four patients (38.6 %) survived 30-day follow-up. Neither hs-cTnT (p = 0.49), nor copeptin (p = 0.39) differed between non-survivors and survivors, whereas NT-proBNP was higher in non-survivors (p < 0.001) and significantly associated with 30-days all-cause mortality in univariate analysis, with a hazard ratio (HR) for patients in the highest compared to the lowest quartile of 4.6 (95% confidence interval (CI), 2.1 – 10.1), p < 0.001. This association was no longer significant in multivariable analysis applying continuous values, [HR 0.96, (95% CI, 0.64 - 1.43), p = 0.84]. Similar results were obtained by dividing the population by survival at hospital admission, excluding non-ROSC patients on-scene [HR 0.93 (95% CI, 0.50 - 1.73), P = 0.83]. We also noted that NT-proBNP was significantly higher in asystole- as compared to VF-patients, p < 0.001.Conclusions: Early-on levels of hs-cTnT, copeptin and NT-proBNP did not provide independent prognostic information following OHCA. Prediction was unaffected by excluding on-scene non-ROSC patients in the multivariable analysis. Clinical Trial Registration: ClinicalTrials. gov, NCT02886273.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

N-Terminal Pro-B-Type Natriuretic Peptide as a Prognostic Indicator for 30-Day Mortality Following Out-of-Hospital Cardiac Arrest: A prospective observational study.

Aarsetøy¹,

Omland

Røsjø

et al. 2020

Preprint

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“…Copeptin has also been demonstrated to be a prognostic marker in AMI-patients ( 14, 15 ), whereas the prognostic value of troponins and copeptin in patients experiencing a cardiac arrest (CA) is less known ( 7, 16 ). B-type natriuretic peptide (BNP) has previously been shown to be an independent predictor of long-term mortality after CA ( 17, 18 ), as well as survival to hospital discharge after OHCA of cardiac origin ( 19 ). There is also a well-documented association between BNP and the short- and long-term risk of death in patients with acute coronary syndrome (ACS) ( 20 ).…”

Section: Introductionmentioning

confidence: 99%

Initial Phase NT-proBNP, but Not Copeptin and High-Sensitivity Cardiac Troponin-T Yielded Diagnostic and Prognostic Information in Addition to Clinical Assessment of Out-of-Hospital Cardiac Arrest Patients With Documented Ventricular Fibrillation

Aarsetøy

Hagve

et al. 2018

Front. Cardiovasc. Med.

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AimSudden cardiac arrest (SCA) secondary to ventricular fibrillation (VF) may be due to different cardiac conditions. We investigated whether copeptin, hs-cTnT and NT-proBNP in addition to clinical assessment may help to identify the etiology of SCA and yield prognostic information.Methods and ResultsEDTA-blood was collected prior to or at hospital admission from patients with SCA of assumed cardiac origin. Clinical data were obtained from hospital records. VF was the primary heart rhythm in 77 patients who initially were divided into 2 groups based on whether they had an ischemic or non-ischemic mechanism as the most likely cause of SCA. They were further divided into 4 groups according to whether or not they had a history of previous heart disease. The patients were categorized by baseline clinical information, ECG, echocardiography and coronary angiography; Group 1 (n = 43): SCA with first AMI, Group 2 (n = 10): SCA with AMI and previous MI, Group 3 (n = 3): SCA without AMI and without former heart disease, Group 4 (n = 18): SCA without AMI and with known heart disease. Copeptin and hs-cTNT did not differ between patient groups, whereas NT-proBNP was significantly higher in patients with established heart disease without AMI and differed between non-AMI and AMI. Furthermore, NT-proBNP was significantly elevated in non-survivors as compared to survivors.ConclusionNT-proBNP provided both diagnostic and prognostic information in blood samples collected close to out-of-hospital resuscitation of VF patients, whereas copeptin and hs-cTnT failed to do so.Clinical Trial RegistrationClinicalTrials.gov, NCT02886273.

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“…The assessment of left ventricle ejection fraction, biomarkers of ventricular dysfunction and the correlation with proinflammatory markers will generate a better understanding of the complexity of PCAS. The N-terminal pro-B-type natriuretic peptide (NT-proBNP) and marinobufagenin are reliable indicators of ventricular dysfunction and, as such, can serve as excellent candidates for future studies on OHCA [43,44].…”

Section: Discussionmentioning

confidence: 99%

Resistin and Cardiac Arrest—A Prospective Study

Tat

Golea

Rahaian

et al. 2019

JCM

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The systemic response to ischemia-reperfusion that occurs after a cardiac arrest (CA) followed by the return of spontaneous circulation leads to endothelial toxicity and cytokine production, both responsible for the subsequent occurrence of severe cardiocirculatory dysfunction and early death. Resistin is emerging as a biomarker of proinflammatory status and myocardial ischemic injury and as a mediator of endothelial dysfunction. The study aimed to analyze the possible associations between several clinical and biological variables and the serum levels of resistin in CA survivors. Forty patients with out-of-hospital resuscitated CA, were enrolled in the study. Demographic, clinical and laboratory data (including serum resistin measurements at admission and at 6, 12, 24, 48 and 72 h) were recorded. For resistin, we calculated the area under the curve (AUC) using the trapezoidal method with measurements from 0 to 12 h, 0 to 24 h, 0 to 48 h and 0 to 72 h. Fifteen (37.5%) patients died in the first 72 h after CA. Cardiovascular comorbidities were present in 65% of patients. The majority of patients had post-CA shock (29 (72.5%)). Resistin serum levels rose in the first 12–24 h and decreased in the next 48–72 h. In univariate analysis, advanced age, longer duration of resuscitation, high sequential organ failure assessment score, high lactate levels, presence of cardiovascular comorbidities and the post-CA shock were associated with higher resistin levels. In multivariate analysis, post-CA shock or cardiovascular comorbidities were independently associated with higher AUCs for resistin for 0–12 h and 0–24 h. The only identified variable to independently predict higher AUCs for resistin for 0–48 h and 0–72 h was the presence of post-CA shock. Our data demonstrate strong independent correlation between high serum resistin levels, cardiac comorbidities and post-CA shock. The impact of the post-CA shock on serum concentration of resistin was greater than that of cardiac comorbidities.

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NT-proBNP in patients with out-of-hospital cardiac arrest: Results from the FINNRESUSCI Study

Cited by 17 publications

References 37 publications

N-Terminal Pro-B-Type Natriuretic Peptide as a Prognostic Indicator for 30-Day Mortality Following Out-of-Hospital Cardiac Arrest: A prospective observational study.

N-Terminal Pro-B-Type Natriuretic Peptide as a Prognostic Indicator for 30-Day Mortality Following Out-of-Hospital Cardiac Arrest: A prospective observational study.

Initial Phase NT-proBNP, but Not Copeptin and High-Sensitivity Cardiac Troponin-T Yielded Diagnostic and Prognostic Information in Addition to Clinical Assessment of Out-of-Hospital Cardiac Arrest Patients With Documented Ventricular Fibrillation

Resistin and Cardiac Arrest—A Prospective Study

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