Abstract 99: Differences of B-Type natriuretic peptide and N-terminal pro B-type natriuretic peptide levels in Patients With Cardiogenic Shock
Background B-Type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are frequently used in diagnosing and monitoring patients with heart failure. Recent studies have demonstrated that BNP and NT-proBNP concentrations reflect LV function and prognosis. However, the role of natriuretic peptides in patients with cardiogenic shock is unclear.
Methods. In 40 patients with cardiogenic shock due to acute myocardial infarction treatment with primary percutaneous transluminal coronary angioplasty (PCI) was performed initially with subsequent medical treatment and intraaortic balloon pump (IABP) counterpulsation. Cardiac catheterization was performed in all patients. Creatinine, Creatinine clearance, LVEDP, and survival were determined, and BNP and NT-proBNP obtained at the start, 24, 48 and 72 hours thereafter. Results. BNP was able to detect differences in treatment regarding LV-unloading. Interestingly, NT-proBNP levels were able to differentiate between survivors and non survivors (4590±1230 vs 14370±4886pg/ml, p<0.05). However, there was no significant difference between survivors and non survivors with regard to BNP levels. Clearly, elevated levels of NT-proBNP in patients with cardiogenic shock were more dependent on decreased renal function which might reflect additional organ dysfunction (24965±9567pg/ml vs 7246±2650, p<0.05).
Conclusions In myocardial infarction complicated cardiogenic shock patients concentrations of BNP and NT-proBNP provide additional information. Our data suggest that the cardiac status and improvement upon therapy can be monitored with BNP. However, NT-pro-BNP is a valuable indicator for prognosis in patients with cardiogenic shock.