Brain natriuretic peptide as a predictor of adverse outcome in patients with pulmonary embolism.
BACKGROUND
Despite effective treatment with anticoagulants, 2% to 7% of patients with pulmonary embolism will die as a result of their disease.


RESULTS
We examined in 110 consecutive patients with pulmonary embolism whether plasma brain natriuretic peptide (BNP), a novel marker of (right) ventricular dysfunction, is a predictor of fatal pulmonary embolism. The relationship between BNP concentration measured at presentation and clinical outcome was assessed by comparing the proportion of outcome events among tertiles. Positive and negative predictive values of BNP levels in the highest and lowest tertiles were calculated. The risk of death related to pulmonary embolism if the BNP level is >21.7 pmol/L is 17% (95% CI, 6% to 33%). The negative predictive value for uneventful outcome of a BNP value <21.7 pmol/L is 99% (95% CI, 93% to 100%).


CONCLUSIONS
This is the first study to show that plasma BNP levels seem to predict adverse outcome in patients with acute pulmonary embolism.
ten Wolde
M
M
Department of Vascular Medicine, F4-138, Academic Medical Center, Meibergdreef 9, PO Box 22660, 1100 DD Amsterdam, The Netherlands. m.tenwolde@amc.uva.nl
Tulevski
I I
II
Mulder
J W M
JW
Söhne
M
M
Boomsma
F
F
Mulder
B J M
BJ
Büller
H R
HR
D006801:Humans; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000401:mortality*; D016019:Survival Analysis
D020097:Natriuretic Peptide, Brain