Tuesday July 22, 2008
Does BNP has any role in predicting mortality in patients with PE

Recent paper by Paul Marik helps to address that issue. In view of high risk of death in patients with pulmonary embolism, it is important to identify the factors associated with high mortality.

Objective: Evaluate the available evidence on (a) the accuracy of brain natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) for the diagnosis of right ventricular dysfunction and (b) their value as a prognostic factor of all-cause in-hospital or short-term mortality in patients with PE.

Results: The pooled diagnostic odds ratio for the diagnosis of right ventricular dysfunction in pulmonary embolism was 39.45 (95% CI; 15.54–100.12) and 24.73 (95% CI 2.02–302.37) for BNP and NT-proBNP, respectively. The pooled odds ratio for all-cause in-hospital or short-term mortality was 6 (95% CI 1.31–27.43; p: 0.021) and 16.12 (95% CI 3.1–83.68; p: 0.001) for BNP (cutoff: 100 pg/ml) and NT-proBNP (cutoff: 600 ng/L), respectively.

Conclusion: This meta-analysis study revealed that high BNP and NT-proBNP level is associated with right ventricular dysfunction in patient with acute PE and are significant predictors of all-cause in-hospital or short-term mortality in these patients.


Reference:

Cavallazzi R, Nair A, Vasu T, Marik P. Natriuretic peptides in acute pulmonary embolism: a systemic review. Intensive care Medicine. Online July 15 2008