Abstract
IntroductionThe interpretation of brain natriuretic peptide (BNP) and Troponin T (TnT) in patients with obesity is very challenging. The applicability of these biomarkers as prognostic indicators of increased mortality in pulmonary embolism (PE) in patients with Grade 3 obesity has yet to be determined.MethodsTo investigate whether the combination of BNP and TnT may help to identify patients at low risk for short-term mortality, we assessed 92 patients admitted with the diagnosis of PE and Grade 3 obesity. The study endpoint was all-cause mortality at 30 days.ResultsThe negative predictive value (NPV) of these tests combined is 98.8%; however, we were not able to detect a statistically significant difference between the patients who had a BNP < 100 pg/mL and TnT < 0.03 ng/mL and the other individuals who had either BNP ≥ 100 pg/mL or TnT ≥ 0.03 or both. The mortality rate was 5.43% within 30 days of the diagnosis. The logistic regression analysis using BNP and troponin as continuous variables identified BNP (p < 0.005) as an independent predictor for 30 days mortality. Receiver operating characteristic (ROC) analysis determined that a BNP level of 684 pg/mL was the cutoff level to predict mortality in the population studied.ConclusionsOur results support that BNP and TnT levels retain an excellent NPV among patients with PE and Grade 3 obesity. BNP testing could be an independent predictor of high-risk patients in this population. The low incidence of all-cause mortality in this study (5.43%) is primarily explained by the more frequent use (9.75%) of systemic or catheter-based thrombolysis associated with a lower rate of major bleeding compared to the general population.
Highlights
The interpretation of brain natriuretic peptide (BNP) and Troponin T (TnT) in patients with obesity is very challenging
Receiver operating characteristic (ROC) analysis determined that a BNP level of 684 pg/mL was the cutoff level to predict mortality in the population studied
Our results support that BNP and TnT levels retain an excellent negative predictive value (NPV) among patients with pulmonary embolism (PE) and Grade 3 obesity
Summary
To investigate whether the combination of BNP and TnT may help to identify patients at low risk for shortterm mortality, we assessed 92 patients admitted with the diagnosis of PE and Grade 3 obesity. Clinical and biochemical data were selected via electronic medical record (EMR) chart review from all consecutive admissions with the diagnosis of acute pulmonary embolism and Grade 3 obesity between 2016. How to cite this article Borz-Baba C, Munir M, Wakefield D, et al (July 19, 2020) Brain Natriuretic Peptide and Troponin T in Patients With Acute Pulmonary Embolism and Grade 3 Obesity: A Retrospective Analysis. Biochemical assay: Samples were analyzed using different types of quantitative methods based on the institution’s medical equipment. BNP was assessed by immunoenzymatic method, Beckman, or immunofluorescence method by TRIAGE. Troponin T (TnT) was analyzed by immunoenzymatic, Becker, or immunofluorescence method by TRIAGE. The cut-off for abnormal TnT was ≥0.03 ng/mL
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