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Intensive Care Med. 2008 Dec;34(12):2147-56. doi: 10.1007/s00134-008-1214-5. Epub 2008 Jul 15.

Natriuretic peptides in acute pulmonary embolism: a systematic review.

Author information

1
Division of Pulmonary and Critical Care Medicine, Thomas Jefferson University, 834 Walnut Street, Suite 650, Philadelphia, PA 19107, USA.

Abstract

BACKGROUND:

Patients with pulmonary embolism (PE) have a high risk of death, and it is important to recognize factors associated with higher mortality. Recently, several biomarkers have been studied for risk stratification in patients with PE.

OBJECTIVES:

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.

DATA SOURCES:

MEDLINE, Embase, and citation review of relevant primary and review articles.

SELECTION CRITERIA:

We selected studies evaluating the accuracy of BNP or NT-proBNP for the diagnosis of right ventricular dysfunction. We also selected studies that reported data on BNP or NT-proBNP as a predictor of short-term mortality in patients with PE.

RESULTS:

Sixteen studies met our inclusion criteria. 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:

The results of this meta-analysis indicate that BNP and NT-proBNP are associated with the diagnosis of right ventricular dysfunction (RVD) in patients with an acute PE and are significant predictors of all-cause in-hospital or short-term mortality in these patients.

PMID:
18626627
DOI:
10.1007/s00134-008-1214-5
[Indexed for MEDLINE]

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