Abstract 79: The Predictive Value of NT-pro BNP in Cardiac Arrest Patients Treated with Mild Hypothermia

Abstract

Background There has not been accurate, independent biomarker to reliably predict neurological outcome in cardiac arrest survivors. B-type natriuretic peptide (BNP) has both prognostic and diagnostic value in heart diseases, and many studies showed NT-pro BNP had more accurate than BNP. We speculated that NT-pro BNP measured after restoration of spontaneous circulation (ROSC) may predict patient outcome. Methods & Results A retrospective review of comatose survivors who were treated with mild therapeutic hypothermia after cardiac arrest due to cardiac origin to two tertiary general hospitals between June 2007 and May 2011 was performed. NT-pro BNP level was checked in 87 patients immediately after ROSC. 35 (40.0%) had a favorable neurological outcome (cerebral performance category 1, 2) and 53 (60.9%) showed survival discharge. The mean value of NT-pro BNP was 557.1±1327.9pg/ml and 5,541.7±9,758.9pg/ml in favorable and unfavorable outcome, respectively (p=0.001). The AUC for favorable neurological outcome was 0.747, and 0.720 for death. The NT-pro BNP cutoff value of 362.7pg/ml for a favorable neurological outcome had a sensitivity of 65% and a specificity of 69%. The cutoff value of 393.8pg/ml for mortality had a sensitivity of 71% and a specificity of 66%. Adjusted odds ratios for favorable neurological outcome at 6 months were 0.686 (95% CI 0.205-2.295), 0.267 (0.0765-0.930), 0.060 (0.11-0.328) compared to the lowest quartile, respectively (p<0.001). Conclusion The measurement of NT-pro BNP had valuable information to predict the neurological outcome for comatose survivors treated with mild hypothermia after out-of-hospital cardiac arrest of cardiac etiology.