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The effect of syncope on brain natriuretic peptide
  1. Matthew J Reed1,
  2. Louise Gibson2
  1. 1Emergency Medicine Research Group, Department of Emergency Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
  2. 2College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
  1. Correspondence to Dr Matthew J Reed, Emergency Department, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK; matthew.reed{at}


Background Brain natriuretic peptide (BNP) may be a good prognostic marker in syncope. The aim of this study was to establish whether there is any change in BNP in association with an acute presentation.

Methods Patients aged ≥60 years admitted following presentation to the emergency department (ED) with syncope were eligible for prospective enrolment. Serial BNP measurements were performed on admission and at intervals up to 4 weeks after presentation.

Results Between 8 March 2010 and 14 April 2010, 31 patients were recruited and were suitable for analysis, including seven patients who returned to the ED at 4 weeks. Mean BNP rose from a baseline of 167.8 ng/ml to a peak of 303.2 ng/ml at 48 h and then returned to baseline at 4 weeks. BNP ratio reached 2.3 (more than twice admission level) at 18 h and peaked at 2.4 at 1 week before returning to baseline at 4 weeks.

Conclusions BNP seems to rise from baseline to a peak between 18 h and 1 week after an acute syncopal episode in many patients. The reasons for this are not clear.

  • arrythmia
  • biochemistry
  • brain natriuretic peptide
  • cardiac care
  • cardiovascular
  • diagnosis
  • emergency medicine
  • syncope

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  • Funding MJR and LG received funding from a chief scientist office small project grant (CSO/CZG/2/444). The sponsor of the study had no role in the study design, data collection, data management, data analysis, data interpretation, or writing of the report. The corresponding author had full access to all the data in the study and has final responsibility for the decision to submit for publication.

  • Competing interests MJR has received a small travel grant from Alere, formally Inverness Medical formally Biosite, to present previous work at the International Conference of Emergency Medicine in 2010.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the South East Scotland Research Ethics Committee 03 (09/S1103/42).

  • Provenance and peer review Not commissioned; externally peer reviewed.