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J Korean Soc Emerg Med > Volume 24(5); 2013 > Article
Journal of The Korean Society of Emergency Medicine 2013;24(5): 508-515.
Serum B-type Natriuretic Peptide Levels for the Prediction of Death in Post-Cardiac Arrest Patients Treated with Therapeutic Hypothermia
Hyun Chul An, Yong Su Lim, Jin Seong Cho, Jin Joo Kim, Hyuk Jun Yang, Won Bin Park, Jae Hyug Woo, Sung Youl Hyun
Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon, Korea. yongem@gilhospital.com
Studies have demonstrated that B-type natriuretic peptide (BNP) has a predictive value for sudden cardiac arrest in heart failure patients. The aim of this study was to investigate the usefulness of serum BNP levels for theprediction of death in post-cardiac arrest patients treated with-therapeutic hypothermia (TH).
Out-of-hospital cardiac arrest (OHCA) survivors treated with TH between April 2007 and August 2010 were evaluated and divided into two groups based on death within 3 months. Initial serum BNP levels were checked and BNP levels compared between both groups.
A total of 162 patients were enrolled in the study. Among 162 patients, 109 patients were male (mean age of 50 years). The BNP levels of the non-survival group (n=77) were higher than those of the survival group (n=85); however, there was no statistical difference (19.45 pg/ml vs. 30.75 pg/ml, p=0.174). The BNP cutoff value of 106 pg/ml for death within 3 months had a sensitivity of 35.1% and a specificity of 78.8%. In the logistic regression analysis, BNP levels higher than 106 pg/ml were significantly associated with death within 3 months (odds ratio [OR], 2.625; 95% confidence interval [CI], 1.066-6.463) and other independent factors were BLS to ROSC (OR, 1.105; CI, 0.082-1.038), non-VF/VT (OR, 3.698; CI, 1.632-8.380), and APACHE II score (OR, 1.117; CI, 1.035-1.204).
Initial Serum BNP levels are related with death within 3 months for patients that received TH after OHCA. However, additional randomized and controlled studies are needed.
Key words: Heart arrest, Cardiopulmonary resuscitation, Brain natriuretic peptide, Induced hypothermia
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