B-type natriuretic peptide as a marker of resuscitation in patients with cardiac arrest outside the hospital.
BACKGROUND
Although the circulating concentration of B-type natriuretic peptide (BNP) has both a prognostic and diagnostic value in heart disease, no data are available regarding its resuscitative value for out-of-hospital cardiac arrest.


RESULTS
The present study was a prospective study of 401 patients whose BNP was measured on arrival at the emergency room after an out-of-hospital cardiac arrest with a cardiac cause. The primary endpoint was survival to hospital discharge. The unadjusted rate of survival to hospital discharge decreased in a stepwise fashion among patients in increasing quartiles of BNP concentration (p<0.001). After adjusting for independent predictors of resuscitation, the odds ratios for survival to hospital discharge in the second, third and fourth quartiles of BNP were 0.13 (95% confidence interval (CI), 0.04-0.46), 0.10 (95% CI, 0.03-0.41), and 0.004 (95% CI, 0.00-0.16), respectively. The BNP cutoff value of 100 pg/ml for survival had a sensitivity of 83% and a negative predictive value of 96%.


CONCLUSIONS
The measurement of BNP was found to provide valuable predictive information for survival to hospital discharge in patients with out-of-hospital cardiac arrest of cardiac etiology.
Nagao
Ken
K
Department of Emergency and Critical Care Medicine, Nihon University School of Medicine, Tokyo, Japan. kennagao@med.nihon-u.ac.jp
Hayashi
Nariyuki
N
Kanmatsuse
Katsuo
K
Kikuchi
Satoru
S
Kikushima
Kimio
K
Watanabe
Kazuhiro
K
Mukouyama
Takeo
T
D000328:Adult; D015415:Biomarkers / Q000097:blood; D016887:Cardiopulmonary Resuscitation; D016001:Confidence Intervals; D004632:Emergency Medical Services; D005260:Female; D006323:Heart Arrest / Q000097:blood* / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D016017:Odds Ratio; D009994:Osmolar Concentration; D010351:Patient Discharge; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D016896:Treatment Outcome
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain