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Cancer patients with markedly elevated B-type natriuretic peptide may not have volume overload
Sukesh C Burjonroppa1, Ann T Tong, Lian-Chun Xiao
1University of Texas Medical School-Houston, Division of Cardiology, Houston, TX 77230-1402, USA.
American Journal of Clinical Oncology
|June 7, 2007
Summary
Markedly elevated B-type natriuretic peptide (BNP) levels in patients with multiple comorbidities are not linked to volume overload or left ventricular dysfunction. Sepsis significantly increases mortality risk in these patients.
Area of Science:
- Cardiology
- Critical Care Medicine
- Biomarkers
Background:
- Elevated B-type natriuretic peptide (BNP) levels typically indicate volume overload and left ventricular (LV) dysfunction in cardiac patients.
- Limited data exists on the significance of markedly elevated BNP in patients with multiple comorbidities.
Purpose of the Study:
- To investigate the association between markedly elevated BNP levels (>1000 pg/mL) and clinical findings of volume overload or LV dysfunction in hospitalized patients with multiple comorbidities.
- To determine the relationship between elevated BNP, sepsis, and 30-day mortality in this patient population.
Main Methods:
- Retrospective analysis of 99 patients with BNP >1000 pg/mL admitted to M. D. Anderson Cancer Center in 2003.
- Clinical characteristics, including volume overload and sepsis, and echocardiographic parameters were assessed.
- Primary outcome was 30-day mortality.
Main Results:
- Median BNP was 2270 pg/mL; no association was found between BNP levels and volume overload or LV dysfunction.
- Most patients (72%) had no volume overload, and 61% had normal LV function.
- Sepsis was present in 53% of patients and was significantly associated with a 2.71-fold increased risk of 30-day mortality.
Conclusions:
- Markedly elevated BNP in patients with multiple comorbidities does not correlate with volume overload or LV dysfunction.
- Elevated BNP in the context of sepsis is a significant predictor of mortality in this complex patient group.
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