Abstract 15943: N-Terminal Pro-Brain Natriuretic Peptide in the Prediction of Short-Term Mortality in Patients With Acute Pulmonary Embolism
Background: Several biomarkers have been studied for risk stratification of patients (P) with acute pulmonary embolism (PE). The potential role of elevated N-terminal pro-brain natriuretic peptide (NT-proBNP) in the differentiation of P suffering from acute PE at risk for adverse clinical outcome has not been fully established. Aim: To evaluate the accuracy of NT-proBNP to predict short-term all-cause mortality in P with acute PE comparatively to other clinical and laboratorial factors.
Methods: Retrospective analysis of consecutive P admitted with acute PE. Study of the value to predict 30-days all-cause mortality of the variables: 1) heart failure clinical signs at admission (NYHA class ≥II), 2) electrocardiographic and 3) echocardiographic signs of right ventricular overload, 4) troponin I and 5) NT-proBNP at admission. Receiver operating curves (ROC) were calculated and the area under the curves (AUC) and 95% confidence interval (CI) were estimated.
Results: Of the 91 included P, 53.8% were men, mean age of 69.3±16.4 years (51.6%≥75 years). The predictive value of the evaluated variables was: 1) AUC 0.520, 95% CI [0.408–0.631], p=0.79, 2) AUC 0.654, 95% CI [0.537–0.759], p=0.03, 3) AUC 0.612, 95% CI [0.491–0.723], p=0.23, 4) AUC 0.574, 95% CI [0.456–0.686], p=0.39, 5) AUC 0.848, 95% CI [0.727–0.930], p<0.001 (cut-off point 4740 pg/ml).
Conclusions: In the studied population of patients with acute pulmonary embolism, NT-proBNP presented the best predictive accuracy for 30-days all-cause mortality.
- © 2010 by American Heart Association, Inc.