Cavallazzi R, et al. Natriuretic peptides in acute pulmonary embolism: a systematic review. Intensive Care Med. 2008 Dec;34(12):2147-56.
Evaluate the available evidence on (a) the accuracy of BNP for the diagnosis of right ventricular dysfunction and (b) value as a prognostic factor of all-cause in-hospital or short-term mortality in patients with PE
16 studies were included in this review; 14 studies addressed BNP in the setting of PE. N of these studies ranged from 17 to 124.
Fig. 3 in the article shows that for BNP cutoff level of 100 pg/ml, the pooled odds ratio for all-cause in-hospital mortality was 6.00
Becattini C, et al. Prognostic value of troponins in acute pulmonary embolism: a meta-analysis. Circulation. 2007 Jul 24;116(4):427-33.
To determine if elevated serum troponin levels identify patients with acute pulmonary embolism at high risk of short-term mortality or adverse outcome.
20 studies (4 retrospective) were included in this review
Results were consistent for troponin I or T and prospective or retrospective studies.
In patients with elevated troponin levels…
- Odds Ratio (OR) for short-term mortality = 5.24 (95% CI, 3.28 to 8.38)
- OR for death resulting from pulmonary embolism = 9.44 (95% CI, 4.14 to 21.49)
- OR for adverse outcome events* = 7.03 (95% CI, 2.42 to 20.43)
*NOTE: Adverse outcome events were defined differently in the studies, but authors chose to pool data because all studies aimed to identify patients experiencing “in-hospital clinical deterioration.”