What question did this study set out to answer?

Determine the prognostic value of elevated brain natriuretic peptide (BNP) or NT-proBNP for short-term all-cause mortality and serious adverse events in acute pulmonary embolism.

August 22, 2008Critical CareOpen Access

Prognostic value of brain natriuretic peptide in acute pulmonary embolism

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Why the study?

Does elevated BNP predict short-term mortality and serious adverse events in patients with acute pulmonary embolism?

Population

12 studies involving a total of 868 patients with documented acute pulmonary embolism at baseline. Excluded…

Comparison

Elevated BNP or N-terminal pro-BNP levels vs Normal BNP or N-terminal pro-BNP levels

Design

Meta-analysis

Follow-up

short-term

Authors

GCGuillaume CoutanceInserm OPOlivier Le PageUniversity of Bath TLTed LoUniversity Hospitals of North Midlands NHS Trust

Discussion

Member takes

Implication

May aid acute PE risk stratification; leaves open prospective validation before guiding management.

Key Points

Determine the prognostic value of elevated brain natriuretic peptide (BNP) or NT-proBNP for short-term all-cause mortality and serious adverse events in acute pulmonary embolism.
Systematic review and random-effects meta-analysis of studies from PubMed, BioMed Central, and the Cochrane database.
Included 12 studies examining BNP or NT-proBNP in 868 patients with confirmed acute pulmonary embolism, excluding those with cardiogenic shock.
Elevated BNP was significantly associated with higher short-term all-cause mortality (OR 6.57, 95% CI 3.11 to 13.91) and pulmonary embolism-related death (OR 6.10, 95% CI 2.58 to 14.25).
Elevated BNP was associated with serious adverse events (OR 7.47, 95% CI 4.20 to 13.15), with a positive predictive value for death of 14% (95% CI 11% to 18%) and a negative predictive value of 99% (95% CI 97% to 100%).

Structured PICO

Does elevated BNP predict short-term mortality and serious adverse events in patients with acute pulmonary embolism?

Population

12 studies involving a total of 868 patients with documented acute pulmonary embolism at baseline. Excluded: patients without certitude of PE or in a subset with cardiogenic shock.

Intervention

Elevated BNP or N-terminal pro-BNP levels

Comparator

Normal BNP or N-terminal pro-BNP levels

Outcome

Short-term all-cause mortalityhard clinical

Elevated BNP levels in acute pulmonary embolism are associated with increased short-term mortality, while normal BNP levels have a 99% negative predictive value for death, helping identify low-risk patients.

Cite This Study

Coutance et al. (2008) studied this question.

synapsesocial.com/papers/6a7f0cdf0d396ca0cf0fc3dd https://doi.org/10.1186/cc6996

Topics

Pulmonary embolism

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