The prognostic value of atrial and brain natriuretic peptides, troponin I and C-reactive protein in patients with sepsis.
OBJECTIVE
To investigate the plasma levels of atrial and brain natriuretic peptides (ANP and BNP), cardiac troponin I (cTnI) and C-reactive protein (CRP) as prognostic factors for survival in patients with sepsis.


METHODS
Evaluation of serum levels of ANP, BNP, cTnI and CRP of patients on admission to an intensive care unit, two days later, and on the day of discharge from the intensive care unit or on the day of death.


RESULTS
ANP levels were significantly higher in the nonsurviving patients (day 1: 70.00+/-49.54 pg/mL; day 2: 138.85+/-143.15 pg/mL; and died/discharged day: 375.70+/-262.66 pg/mL) than surviving patients (day 1: 23.96+/-29.93 pg/mL; day 2: 10.06+/-6.03 pg/mL; died/discharged day: 6.68+/-100.98 pg/mL, P<0.001). The BNP levels were significantly higher in the nonsurvivors (day 1: 254.78+/-308.62 pg/mL; day 2: 383.22+/-307.19 pg/mL; and died/discharged day: 696.47+/-340.33 pg/mL), than survivors (day 1: 13.72+/-12.95 pg/mL; day 2: 7.20+/-5.85 pg/mL; died/discharged day: 4.51+/-4.64 pg/mL, P<0.001). The cTnI levels were significantly higher in the nonsurviving patients (day 2: 0.16+/-0.38 mug/L; died/discharged day: 0.78+/-2.48 mug/L) than surviving patients (day 2: 0.04+/-0.07 mug/L; died/discharged day: 0.02+/-0.01 mug/L, P<0.05). The CRP levels were significantly higher in the nonsurvivors (day 2: 119.3+/-71.5 mg/L; and died/discharged day: 145.7+/-74.7 mg/L) than survivors (day 2: 57.0+/-29.7 mg/L; died/discharged day: 26.8+/-24.0 mg/L, P<0.05). There were no significant differences between nonsurvivors and survivors for cTnI and CRP on day 1.


CONCLUSIONS
With the exception of cTnI and CRP on day 1, all of the parameters were significantly powerful to determine nonsurvivors on all days. Among these variables, BNP was the most powerful diagnostic parameter for the prediction of nonsurvivors on all days.
Yucel
Tuba
T
Department of Anaesthesiology and Reanimation, Faculty of Medicine, Trakya University, Edirne, Turkey.
Memiş
Dilek
D
Karamanlioglu
Beyhan
B
Süt
Necdet
N
Yuksel
Mahmut
M