title: Prognostic value of troponin I and NT-proBNP concentrations in patients after in-hospital cardiac arrest.
abstract: OBJECTIVE
  Cardiac arrest (CA) is a complex event with a dismal survival rate. The aim of this study was to determine whether N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels measured on admission and serial cardiac troponin I determination in patients with in-hospital cardiac arrest (IHCA) are predictive of 30-day mortality.
  
  
  METHODS
  Out of 9877 patients hospitalized in the cardiac intensive care unit during the study, we enrolled consecutive patients experiencing cardiac arrest within 12 hours of admission. Baseline characteristics, information about circumstances of CA and cardiopulmonary resuscitation, and initial biochemical parameters were retrospectively collected.
  
  
  RESULTS
  A total of 106 patients (61 male, age 71.4±12.6 years) were enrolled. Thirty-four (32.1%) had a history of myocardial infarction, and 13 (12.3%) a history of stroke. Total 30-day mortality was 60.4%. Deceased patients were older (73.7±11.9 vs. 67.8±13.0 years; p=0.01) and had lower systolic (89.4±37.0 vs. 115.0±24.0 mmHg; p=0.0001) and diastolic (53.6±24.8 vs. 66.1±15.0 mmHg; p=0.008) blood pressure on admission. Shockable initial rhythm was more often noted in the survivor group (54.8% vs. 28.1%; p=0.01). Deceased patients had higher median NT-proBNP levels (9590.0 [25-75% interquartile range (IQR), 5640.0-26450.0] vs. 3190.0 [25-75% IQR, 973.8-5362.5] pg/ml; p=0.02) on admission. There were no differences in the first two troponin I measurements, but values were higher on the third measurement in non-survivors (98.2 [25-75% IQR, 76.4-175.8] vs. 18.7 [25-75% IQR, 5.2-50.6]; p=0.009).
  
  
  CONCLUSIONS
  The survival rate of patients after in-hospital CA is poor. Deceased patients have higher NT-proBNP levels on admission, along with higher troponin I concentrations on the third measurement. Those biomarkers are useful in predicting 30-day mortality in IHCA patients.
authors.affiliation: Department of Cardiology, Medical University of Warsaw, Poland.
authors.forename: Anna E
authors.initials: AE
authors.lastname: Platek
authors.affiliation: Department of Cardiology, Medical University of Warsaw, Poland. Electronic address: fillip.szymanski@wum.edu.pl.
authors.forename: Filip M
authors.initials: FM
authors.lastname: Szymanski
authors.affiliation: Department of Cardiology, Medical University of Warsaw, Poland.
authors.forename: Krzysztof J
authors.initials: KJ
authors.lastname: Filipiak
authors.affiliation: Department of Cardiology, Medical University of Warsaw, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Karpinski
authors.affiliation: Department of Cardiology, Hypertension and Internal Diseases, Medical University of Warsaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Hrynkiewicz-Szymanska
authors.affiliation: Department of Cardiology, Medical University of Warsaw, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Kotkowski
authors.affiliation: Department of Cardiology, Medical University of Warsaw, Poland.
authors.forename: Robert
authors.initials: R
authors.lastname: Kowalik
authors.affiliation: Department of Cardiology, Medical University of Warsaw, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Opolski
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D006323:Heart Arrest / Q000097:blood* / Q000401:mortality*; D006760:Hospitalization; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D019210:Troponin I / Q000097:blood*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D019210:Troponin I; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: In-hospital cardiac arrest; Mortalidade; Mortality; NT-proBNP; Paragem cardíaca intra-hospitalar; Troponin I; Troponina I