Abstract 14067: Initial Phase NT-proBNP, but not Copeptin and High-Sensitivity Cardiac Troponin-T Yielded Valuable Information in Addition to Clinical Assessment of Out-of-Hospital Cardiac Arrest Patients
Introduction: Sudden cardiac arrest (SCA) secondary to ventricular fibrillation may be due to different underlying heart diseases. Hs-cTnT is a commonly used marker of myocardial necrosis, but there remains a troponin-blind period shortly after symptom onset. Circulating copeptin levels have been found to be significantly elevated during the initial ischemic phase of an AMI, providing early diagnostic information. Whether this may help to differentiate the underlying cause of SCA, is not known.
Hypothesis: We analyzed copeptin, hs-cTnT and NT-proBNP to investigate whether these biomarkers could provide information to categorize out-of-hospital cardiac arrest (OHCA) patients in addition to clinical evaluation.
Methods: From February 2007 until December 2010 prehospital EDTA-blood was collected from patients aged > 18 years with OHCA of assumed cardiac origin in collaboration with EMS paramedics. For patients with return of spontaneous circulation who did not have a prehospital blood sample, EDTA-blood was taken at hospital admission. Clinical data for classification was obtained from hospital records.
Results: 77 patients with OHCA had documented VF as primary heart rhythm. They were divided into 4 groups according to the most likely cause of SCA, applying previous and current clinical information, supported by ECG, echocardiography and coronary angiography; Group 1 (n=43): SCA with first MI, Group 2 (n=10): SCA with AMI and previous MI, Group 3 (n=3): SCA without AMI and without former heart disease, Group 4 (n=18): SCA without AMI and with known heart disease.
There was no statistically significant difference between the four groups, comparing conventional copeptin, ultrasensitive copeptin and hs-cTNT. Group 4 had a significantly higher mean value for NT-proBNP of 405,1 pmol/L (SD 569,9) as compared to the other 3 groups (Group 1: NT-proBNP 68,23 pmol/L (SD 123,6), Group 2: NT-proBNP 61,99 pmol/L (SD 66,07) and Group 3: NT-proBNP 24,67 pmol/L (SD 35,18), p-value 0,001).
Conclusions: Hs-cTnT and copeptin collected during or immediately after resuscitation was not found to be useful for the diagnosis of AMI as the cause of SCA, whereas NT-proBNP was found to be significantly elevated in SCA patients with established heart disease and no AMI (Group 4).
Author Disclosures: R. Aarsetoey: None. H. Aarsetoey: None. T. Hagve: None. H. Strand: None. H. Staines: None. D. Nilsen: None.
- © 2016 by American Heart Association, Inc.