Friday January 12, 2007
BNP and Troponin in Pulmonary Embolism !!



One study published in European Heart Journal couple of years ago looking into the relationship of Troponin-T (cTnT) and NT-proBNP levels in PE. In 100 "normotensive" patients

• There was no death with NT-proBNP less than 600 ng/L (40 days follow-up)
• There was intermediate risk of death with NT-ProBNP more than 600 ng/L but cTnT level less than 0.07 µg/L
• Mortality was 33% in patients with NT-proBNP more than 600 ng/L and cTnT level less than 0.07 µg/L

Clinical significance: In patients, though nomotensive, if BNP and Troponin levels are high and echocardiogram shows RV dysfunction - start thinking of thrombolytics. This consideration becomes more important if CVP is already 8-12 (means patient is euvolumic) and ScVO2 (central venous oxygen saturation) is less than 70%.

Read full article Thrombolytics in Pulmonary Embolism: Risk Stratification and Timing - published in Critical Connections, December 2006 from Chee Chan, MD (Brown University, Rhode Island Hospital Providence, Rhode Island) and Andrew Stone, MD (Providence VA Medical Center, Providence, Rhode Island).


Reference: click to get abstract

1. “Biomarker-based risk assessment model in acute pulmonary embolism.” European Heart Journal, Volume 26, Number 20 Pp. 2166-2172