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BNP worsens 12 days after alcohol cessation while other cardiovascular risk biomarkers improve: An observational
Virgile Clergue-Duval1, Reka Sivapalan2, Eric Hispard3
1APHP, Département de Psychiatrie et de Médecine Addictologique, Hôpital Lariboisière Fernand-Widal, Groupe Hospitalier Universitaire APHP Nord - Université de Paris, Paris, France; Inserm UMRS-1144 Optimisation Thérapeutique en Neuropsychopharmacologie, Université de Paris, Paris, France; Fédération Hospitalo-Universitaire Network of Research in Substance Use Disorders, Ile-de-France, France; Faculté de Médecine, Université de Paris, Paris, France.
Insights
Alcohol cessation rapidly improves cardiovascular risk factors in patients with alcohol use disorder. However, brain natriuretic peptide (BNP) levels increased, suggesting it may be a biomarker for cardiac function during alcohol withdrawal.
Area of Science:
- Cardiology
- Addiction Medicine
- Biomarkers
Background:
- Alcohol use disorder (AUD) is linked to high cardiovascular risk factors (CRFs) and premature mortality.
- Abstinence from alcohol offers long-term health benefits, but short-term cardiac effects are understudied.
- Understanding cardiac function changes during alcohol cessation is crucial for patient management.
Purpose of the Study:
- To evaluate the short-term impact of alcohol cessation on cardiac function and CRFs in hospitalized AUD patients.
- To assess changes in brain natriuretic peptide (BNP) and other CRFs 12 days after admission for alcohol cessation.
Main Methods:
- Retrospective chart review of 55 inpatients with AUD hospitalized for alcohol cessation.
- Comparison of BNP levels and CRFs (hemodynamic, electromyographic, lipid, homocysteine, liver enzymes) at admission and day 12.
- Statistical analysis included Wilcoxon, Student tests, and repeated-measures ANOVA.
Main Results:
- BNP levels significantly increased from 11.8 pg/mL to 35.5 pg/mL (p < 0.001) by day 12.
- Significant improvement was observed in 8 out of 13 other CRFs and liver enzymes (p ≤ 0.05).
- No significant interaction was found between BNP variation and baseline BNP levels.
Conclusions:
- Alcohol cessation leads to rapid improvement in several CRFs within 12 days.
- The observed increase in BNP warrants further investigation as a potential biomarker for cardiac function during alcohol withdrawal.
- BNP may serve as an indicator of cardiac stress or adaptation during the early stages of alcohol cessation.
Abstract:
Subjects with alcohol use disorder (AUD) display a high prevalence of cardiovascular risk factors (CRFs), and a high incidence of cardiovascular diseases associated with an earlier mortality. Abstinence has long-term cardiovascular and global health benefits. However, few studies have examined the short-term effect of alcohol cessation on cardiac function and key CRFs. The aim of the study was to assess brain natriuretic peptide (BNP) and other CRFs on admission for alcohol cessation and 12 days later, in inpatients with AUD. A retrospective chart review of inpatients hospitalized for alcohol cessation was conducted. Patients who did not relapse at day 12 were included. We compared, at entry and at day 12, BNP and other CRFs: hemodynamic and electromyographic variables, lipid, homocysteine level, and liver enzymes at entry and at day 12. Wilcoxon, Student tests, and repeated-measures ANOVA were conducted. Fifty-five patients were included (38 males, mean age 50.5 years, alcohol per day 60 g-750 g, 44 current tobacco smokers). BNP was significantly increased (11.8 pg/mL [±16.2] to 35.5 pg/mL [±47.6], p < 0.001). Repeated-measure ANOVA showed a significant between-subject effect (p = 0.024), but no significant interaction between BNP variation and having a BNP at entry >10 pg/mL (p = 0.092). In contrast, a significant improvement on 8 of 13 other CRFs and liver enzymes measures was observed (p ≤ 0.05). A rapid improvement of several CRFs was confirmed. However, the increase of BNP at day 12 supports its investigation as a possible relevant biomarker of cardiac function in alcohol withdrawal.
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