Predictive Role Of Nt-Pro Bnp For Adverse Cardiac Events In Community-Acquired Pneumonia: A Retrospective Study

Aims: We aim to investigate the predictive role of N-Terminal pro-B-type brain natriuretic peptide (NT-pro BNP) for adverse cardiac events in community-acquired pneumonia (CAP). Methods: A total of 372 consecutive patients with CAP in Beijing Luhe Hospital from January 2012 to December 2014 were included into this study. Based on initial serum CRP level, patients were separated into group A (<20 mg/L, group B (20-100 mg/L) and group C (>100 mg/L). Primary endpoint was the risk of major adverse cardiac events (MACE). Results: NT-pro BNP levels increased with CAP severity (r=0.58, P<0.001). Additionally, Plasma NT-pro BNP was correlated significantly with inflammatory markers. After a mean follow-up of 12.8 months, MACE occurred in 29 (7.8%) patients. There were no significant differences between the three groups in the length of ventilation, hospital length of stay and rate of cardiac mortality, heart failure and acute coronary syndrome. However, the risk of MACE was markedly different between the groups (P<0.05). NT-pro BNP levels of 210.5 ng/L was the boundary value of CAP-associated myocardial injury (sensitivity 84.2%, specificity 73.1%). Moreover, NT-pro BNP levels of 461.2 ng/L was the boundary value of MACE (sensitivity, 73.9%; specificity, 79.5%). Conclusions: Our study found that NT-pro BNP increased with severity of CAP increasing. Moreover, NT-pro BNP level was an effective predictor of cardiac injury and adverse cardiac events for patients with CAP, which might be related with bacterial endotoxins and inflammatory mediators. More studies are needed to confirm our finding.