The significance of B-type natriuretic peptide in predicting early mortality among pulmonary embolism patients, alongside troponin: insights from a multicentric registry

Benic Marija,Bozovic Bjanka,Bulatovic Nebojsa,Djuric Ivica,Dzudovic Boris,Dzudovic Jelena,Kafedzic Srdjan,Kos Ljiljana,Kovacevic-Preradovic Tamara,Matijasevic Jovan,Miloradovic Vladimir,Mitevska Irena,Mitrovic Bojan,Neskovic Aleksandar,Obradovic Slobodan,Salinger Sonja,Simpson Tamara,Subotic Bojana

doi:10.1016/j.cpcardiol.2024.102437

Abstract

BackgroundEarly mortality assessment in acute pulmonary embolism (PE) is crucial for treatment decisions. The role of natriuretic peptides in this context is debated. This study explores elevated B-type natriuretic peptide (BNP) levels, relative to the upper normal limit (UNL), predicting mortality in PE, comparing with troponin (Tn). MethodologyA multicenter PE registry analyzed predictive values for early mortality risk using BNP and Tn, based on proportional elevation to the UNL. Patients followed current PE guidelines. ResultsAmong 1677 PE patients, BNP's AUC exceeded Tn for all-cause (0.727 vs. 0.614) and PE-related mortality (0.785 vs. 0.644), though nonsignificant. BNP's cutoff was 3.5 times UNL for both all-cause and PE-related mortalities; Tn cutoffs were 1.38 and 1.23 times UNL, respectively. ConclusionElevated BNP relative to UNL significantly predicts all-cause and PE-related mortality. While akin to Tn, BNP merits consideration in assessing acute PE risk, especially in intermediate-high-risk cases.

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