Aarsetøy Reidun, Aarsetøy Hildegunn, Hagve Tor-Arne, Strand Heidi, Staines Harry, Nilsen Dennis W T
Division of Cardiology, Stavanger University Hospital, Stavanger, Norway.
Department of Medicine, Stavanger University Hospital, Stavanger, Norway.
Front Cardiovasc Med. 2018 Jun 7;5:44. doi: 10.3389/fcvm.2018.00044. eCollection 2018.
Sudden cardiac arrest (SCA) secondary to ventricular fibrillation (VF) may be due to different cardiac conditions. We investigated whether copeptin, hs-cTnT and NT-proBNP in addition to clinical assessment may help to identify the etiology of SCA and yield prognostic information.
EDTA-blood was collected prior to or at hospital admission from patients with SCA of assumed cardiac origin. Clinical data were obtained from hospital records. VF was the primary heart rhythm in 77 patients who initially were divided into 2 groups based on whether they had an ischemic or non-ischemic mechanism as the most likely cause of SCA. They were further divided into 4 groups according to whether or not they had a history of previous heart disease. The patients were categorized by baseline clinical information, ECG, echocardiography and coronary angiography; Group 1 (n = 43): SCA with first AMI, 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. Copeptin and hs-cTNT did not differ between patient groups, whereas NT-proBNP was significantly higher in patients with established heart disease without AMI and differed between non-AMI and AMI. Furthermore, NT-proBNP was significantly elevated in non-survivors as compared to survivors.
NT-proBNP provided both diagnostic and prognostic information in blood samples collected close to out-of-hospital resuscitation of VF patients, whereas copeptin and hs-cTnT failed to do so.
ClinicalTrials.gov, NCT02886273.
心室颤动（VF）继发的心搏骤停（SCA）可能由不同的心脏疾病引起。我们研究了除临床评估外， copeptin、高敏心肌肌钙蛋白T（hs-cTnT）和N末端B型利钠肽原（NT-proBNP）是否有助于识别SCA的病因并提供预后信息。
从假定为心脏源性SCA的患者入院前或入院时采集乙二胺四乙酸（EDTA）抗凝血。临床数据从医院记录中获取。VF是77例患者的主要心律，这些患者最初根据SCA最可能的病因是缺血性还是非缺血性机制分为2组。根据他们是否有既往心脏病史，进一步分为4组。根据基线临床信息、心电图、超声心动图和冠状动脉造影对患者进行分类；第1组（n = 43）：首次急性心肌梗死（AMI）伴SCA，第2组（n = 10）：AMI伴既往心肌梗死（MI）伴SCA，第3组（n = 3）：无AMI且无既往心脏病的SCA，第4组（n = 18）：无AMI但有已知心脏病的SCA。患者组间copeptin和hs-cTNT无差异，而无AMI的确诊心脏病患者的NT-proBNP显著更高，且在非AMI和AMI患者之间存在差异。此外，与幸存者相比，非幸存者的NT-proBNP显著升高。
在接近院外对VF患者进行复苏时采集的血样中，NT-proBNP提供了诊断和预后信息，而copeptin和hs-cTnT未能做到这一点。
ClinicalTrials.gov，NCT02886273。
