Predictive Power of N-terminal Prohormone of Brain Natriuretic Peptide on Admission and on Discharge for Short- and Long-term Clinical and Echocardiographic Outcomes in Patients With Pulmonary Thromboembolism

Abstract

<span><strong><em>Background: </em></strong><span>This prospective case-series study was conducted to determine the predictive<span> power of the N-terminal prohormone of brain natriuretic peptide (NT-proBNP) on shortand long-term outcomes in patients with pulmonary thromboembolism (PTE).<br /><span><strong><em>Methods: </em></strong><span>Ninety-two patients (age = 60 ± 1.97 y, 54.7% male) diagnosed with PTE were<span> recruited. NT-proBNP levels and echocardiographic indices were measured and recorded.<span> The primary endpoint was considered to be 3-month PTE-related deaths and long-term<span> adverse outcomes including 1-year all-cause mortality, rehospitalization due to the<span> recurrence of PTE, right ventricular dysfunction, and pulmonary hypertension.<br /><span><strong><em>Results: </em></strong><span>The serum NT-proBNP level and the right ventricular diameter were significantly<span> higher in the patients with adverse outcomes than in the outcome-free patients. Several<span> significant correlations were found between NT-proBNP levels and echocardiographic<span> indices. During a mean follow-up time of 12 months, 1 patient suffered PTE relapse, 15<span> patients had right ventricular dysfunction and pulmonary hypertension, and 2 patients<span> expired. Age was an independent value in the prediction of the adverse outcome (OR:<span> 1.064, 95% CI: 1.01 to 1.11). Discharge NT-proBNP levels, calculated according to a<span> multiple cutoff point strategy for heart failure, in the PTE patients with adverse outcomes<span> was 2.36 fold that in the outcome-free patients. The optimal value for discharge NTproBNP according to the receiver operating characteristic analysis was 327 pg/mL, with a<span> sensitivity of 80% and a specificity of 43%.<br /><span><strong><em>Conclusions: </em></strong><span>NT-proBNP measurement during the course of PTE, especially on discharge, may<span> have a role as an easy-to-use diagnostic tool for determining patients with poor<span> prognoses.</span></span></span><br /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span>