Revista argentina de cardiología
versión On-line ISSN 1850-3748
JAIMOVICH, Guillermo et al. Prognostic value of brain natriuretic peptide and troponin I in moderate and high risk pulmonary embolism. Rev. argent. cardiol. [online]. 2012, vol.80, n.4, pp. 292-298. ISSN 1850-3748.
Prognostic value of brain natriuretic peptide and troponin I in moderate and high risk pulmonary embolism Background Brain natriuretic peptide (BNP) and troponins are useful markers for risk stratification in pulmonary embolism (PE). However, it is not clear which of the two biomarkers has better association with the clinical severity of this condition. Objective The aim of this study was to assess both biomarkers in moderate and high risk PE populations. Methods A prospective study was undertaken to analyze all patients diagnosed with PE who had positive troponin I (TI) or BNP levels. An echocardiogram within the first 24 hours and clinical follow up during hospitalization were performed on these patients. A composite endpoint of death, recurrent PE, shock, hypotension, mechanical ventilation and thrombolytic therapy was established. The association of both serum markers with the described events was assessed. Results Seventy one consecutive patients were included in this study. Patients with moderate or severe right ventricular dysfunction had higher BNP levels (661 pg/ml (420-1113) vs. 316 pg/ ml (129-570) p=0.002) without significant difference in TI levels (0.115 ng/ml (0.015-0.345) vs. 0.24 ng/ml (0.076-0.58) p=0.0788). BNP levels were higher in patients with composite endpoint 604 pg/ml (370-934) vs. 316 pg/ml (148-900) p=0.042, whereas no similar association was found for TI 0.12 ng/ml (0.037-0.48) vs. 0.13 ng/ml (0.07-0.41) p=0.46. Conclusions BNP showed higher values in patients with right ventricular dysfunction and composite endpoint, indicating its greater sensitivity to identify patients with more severe clinical involvement.
Palabras clave : Pulmonary Embolism; Brain Natriuretic Peptide; Troponin; Prognosis.