September 7, 2005Circulation
N-Terminal Pro–Brain Natriuretic Peptide or Troponin Testing Followed by Echocardiography for Risk Stratification of Acute Pulmonary Embolism
Key result
A positive echocardiogram combined with elevated NT-proBNP was associated with a 12-fold elevation in complication risk compared with patients with low NT-proBNP (P=0.002).
Why the study?
Does the combination of NT-proBNP or troponin testing with echocardiography improve risk stratification for death or major in-hospital complications in patients with acute pulmonary embolism?
Population
124 consecutive patients with proved acute pulmonary embolism (PE)
Comparison
Combination of NT-proBNP or troponin testing… vs NT-proBNP or troponin testing alone, or low…
Design
Cohort
Follow-up
in-hospital
Authors
Discussion
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Implication
May aid risk stratification in acute PE; hypothesis-generating and requires prospective validation before guiding care.
Key Points
- This research aims to evaluate the effectiveness of NT-proBNP and troponin testing in conjunction with echocardiography for risk stratification in acute pulmonary embolism.
- Examined 124 consecutive patients with proved pulmonary embolism (PE) undergoing echocardiography on admission.
- Measured NT-proBNP and troponin concentrations in a core laboratory to assess risk components.
- Primary endpoint assessed was death or major in-hospital complications.
- A positive echocardiogram was linked to a 12-fold increase in the risk of complications compared to patients with low NT-proBNP (P=0.002).
- NT-proBNP elevation alone, without right ventricular dysfunction, slightly raised the risk of adverse outcomes (P=0.17).
- Troponin testing combined with echocardiography produced similar risk elevation patterns across different risk groups.
Study Design
Type
Observational (n=124)
Structured PICO
Does the combination of NT-proBNP or troponin testing with echocardiography improve risk stratification for death or major in-hospital complications in patients with acute pulmonary embolism?
P
Population
124 consecutive patients with proved acute pulmonary embolism evaluated for in-hospital complications.
E
Exposure
Combination of NT-proBNP or troponin testing with echocardiography on admission
C
Comparator
NT-proBNP or troponin testing alone, or low biomarker levels
O
Outcome
Death or major in-hospital complicationscomposite
Main Result
Effect estimate: 12-fold elevation in risk
p-value: p=0.002
Combining NT-proBNP or troponin testing with echocardiography effectively risk-stratifies patients with acute pulmonary embolism, identifying those at highest risk for in-hospital complications.
Cite This Study
Binder et al. (2005) conducted an observational in Acute pulmonary embolism (n=124). Elevated NT-proBNP with positive echocardiogram vs. Low NT-proBNP was evaluated on Death or major in-hospital complications (12-fold elevation in risk, p=0.002). A positive echocardiogram combined with elevated NT-proBNP was associated with a 12-fold elevation in complication risk compared with patients with low NT-proBNP (P=0.002).