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. 2008 Winter;13(4):183-8.

The prognostic value of atrial and brain natriuretic peptides, troponin I and C-reactive protein in patients with sepsis

Tuba Yucel  1 , Dilek Memiş, Beyhan Karamanlioglu, Necdet Süt, Mahmut Yuksel
Affiliations

The prognostic value of atrial and brain natriuretic peptides, troponin I and C-reactive protein in patients with sepsis

Tuba Yucel et al. Exp Clin Cardiol. 2008 Winter.

Abstract

Aim: 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.

Method: 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.

Conclusion: 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.

Keywords: C-reactive protein; Intensive care unit; Natriuretic peptides; Prognosis; Sepsis; Troponin I.

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Figures

Figure 1)
Figure 1)
Receiver operating characteristic curves showing the association between parameters (atrial natriuretic peptides [ANP], brain natriuretic peptides [BNP], troponin I, C-reactive protein [CRP], and Acute Physiology and Chronic Health Evaluation II scores [APACHE II]) and survival outcome on day 1 in the intensive care unit
Figure 2)
Figure 2)
Receiver operating characteristic curves showing the association between parameters (atrial natriuretic peptides [ANP], brain natriuretic peptides [BNP], troponin I, C-reactive protein [CRP], and Acute Physiology and Chronic Health Evaluation II scores [APACHE II]) and survival outcome on day 2 in the intensive care unit
Figure 3)
Figure 3)
Receiver operating characteristic curves showing the association between parameters (atrial natriuretic peptides [ANP], brain natriuretic peptides [BNP], troponin I, C-reactive protein [CRP], and Acute Physiology and Chronic Health Evaluation II scores [APACHE II]) and survival outcome on the last day
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