Abdelaziz Gomaa
Zagazig University
Title: Does N-terminal pro-brain natriuretic peptide level predict prognosis of acute pulmonary embolism?
Biography
Biography: Abdelaziz Gomaa
Abstract
Background: Patients with acute Pulmonary Embolism (PE) have a high risk of death. N-terminal pro-brain natriuretic peptide (NT-pro BNP) has emerged as a biomarker for risk assessment in acute PE.
Aim: We aimed to detect in hospital prognostic value NT- pro BNP in patients with acute PE.
Methods: 64 patients with acute PE were studied. All patients were subjected to ECG, laboratory tests (D-dimer, troponin I, NT-pro BNP), Doppler ultrasound for the venous system of lower limbs, transthoracic echocardiography and 64 multi-slices CT pulmonary angiography.
Results: Patients were divided into two groups: group I (22) patients with normal NT-pro BNP (<300 pg/ml), and group II (42) patients with elevated NT-pro BNP. Group II had higher incidence of heart failure (28.6% vs. 4.6% P=0.025), impaired kidney function (creatinine 1.7±0.6 vs. 1.1±0.2, P=0.018) and cardiogenic shock (26.2% vs. 0% P=0.014) but lower incidence of chest pain (21.4% vs. 45.5% P=0.04) and lower LV ejection fraction (51.3%±16.9% vs. 67.3%±12.8% P=0.043) compared to group I. Group II had higher treatment with thrombolytic therapy (35.7% vs. 9.1%, P= 0.021) and positive inotropic (35.71% vs. 4.55%, P=0.006), higher need for mechanical ventilation (26.2% vs. 4.55%, P=0.04), longer hospital stay (19.5±10.3 vs. 5.3±4.5, p=0.001) and higher mortality (19.05% vs. 0.0% P=0.042) than group I.
Conclusion: Elevated NT-pro BNP levels in patients with PE are associated with worse short term prognosis in terms of higher morbidity and mortality and it could be used as a valuable prognostic parameter and good indicator for the need of more aggressive therapy.