title: Usefulness of N-terminal pro-brain natriuretic peptide levels to predict success of weaning from intra-aortic balloon pumping.
abstract: There is currently no reliable method of predicting the success of weaning from intra-aortic balloon pumping (IABP). The aim of this study was to investigate the ability of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level to predict the success of weaning from IABP. Consecutive patients scheduled for weaning from IABP were prospectively enrolled. NT-proBNP levels were measured at baseline (before the start of weaning) and cessation (just before cessation of IABP). Changes in NT-proBNP level between baseline and cessation were analyzed in 2 groups of patients: those who were successfully weaned and those who were not successfully weaned for any reason, including a decision to discontinue weaning, worsening of pulmonary edema after cessation of IABP, or unstable hemodynamics after cessation of IABP. A total of 30 patients were enrolled (mean age 66 ± 12 years, 16 men, 16 with acute myocardial infarctions, and 14 with acute exacerbation of chronic heart failure). Median (interquartile range) baseline NT-proBNP levels were not significantly different between the successful and unsuccessful weaning groups (4,200 [1,400 to 8,752] pg/ml vs (5,620 [2,035 to 13,950] pg/ml, p = 0.30). In the unsuccessful weaning group, the median NT-proBNP level was significantly higher at cessation (9,995 [2,920 to 15,100] pg/ml) than at baseline (p = 0.008). All patients with decreases in NT-proBNP level between baseline and cessation were successfully weaned from IABP. In conclusion, these results show that NT-proBNP levels were useful for predicting the success of weaning from IABP. If the NT-proBNP level increases during weaning from IABP, more intense management should be considered.
authors: Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan. Electronic address: yukichi@nms.ac.jp.
authors: Yukichi
authors: Y
authors: Tokita
authors: Division of Intensive and Cardiovascular Care, Nippon Medical School Hospital, Tokyo, Japan.
authors: Takeshi
authors: T
authors: Yamamoto
authors: Department of Internal Medicine and Cardiology, Nippon Medical School Musashi-Kosugi Hospital, Kanagawa, Japan.
authors: Naoki
authors: N
authors: Sato
authors: Division of Intensive and Cardiovascular Care, Nippon Medical School Hospital, Tokyo, Japan.
authors: Yusuke
authors: Y
authors: Hosokawa
authors: Department of Cardiology, Nippon Medical School Chiba Hokusou Hospital, Chiba, Japan.
authors: Ryo
authors: R
authors: Munakata
authors: Division of Intensive and Cardiovascular Care, Nippon Medical School Hospital, Tokyo, Japan.
authors: Koichi
authors: K
authors: Akutsu
authors: Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
authors: Wataru
authors: W
authors: Shimizu
authors: Division of Intensive and Cardiovascular Care, Nippon Medical School Hospital, Tokyo, Japan.
authors: Keiji
authors: K
authors: Tanaka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood / Q000628:therapy*; D006801:Humans; D007118:Immunoassay; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain