Does proBNP level predict adverse clinical outcomes in patients with acute pulmonary embolism?
Low proBNP levels (<500 pg/mL) reliably predict a benign in-hospital course in acute pulmonary embolism, potentially identifying candidates for early discharge or outpatient management.
BACKGROUND: The role of pro-brain natriuretic peptide (proBNP) for the prediction of clinical outcome has not been examined in patients with acute pulmonary embolism (PE). METHODS AND RESULTS: ProBNP levels were measured in 73 patients with acute PE within 4 hours of admission. Adverse clinical outcome was defined as in-hospital death or the need for at least 1 of the following: cardiopulmonary resuscitation, mechanical ventilation, pressors, thrombolysis, catheter fragmentation, or surgical embolectomy. In the 53 patients with a benign clinical outcome, proBNP (median 121, range 16 to 34 802 pg/mL) was lower than in 20 patients with adverse clinical outcome (median 4250, range 92 to 49 607 pg/mL; P0.01 ng/mL, age >70 years, gender, and history of congestive heart failure. CONCLUSIONS: Low proBNP levels predict an uneventful hospital course in patients with acute PE. A proBNP level <500 pg/mL identifies patients who will be potential candidates for an abbreviated hospital length of stay or care on a completely outpatient basis.
Kucher et al. (2003) studied this question.