This Readership is 10 times more when compared to other Subscription Journals (Source: Google Analytics)
All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.
Background: Patients with acute Pulmonary Embolism (PE) have a high risk of death. N-terminal pro-brain natriuretic
peptide (NT-pro BNP) has emerged as a biomarker for risk assessment in acute PE.
Aim: We aimed to detect in hospital prognostic value NT- pro BNP in patients with acute PE.
Methods: 64 patients with acute PE were studied. All patients were subjected to ECG, laboratory
tests (D-dimer, troponin I, NT-pro BNP), Doppler ultrasound for the venous system of lower
limbs, transthoracic echocardiography and 64 multi-slices CT pulmonary angiography.
Results: Patients were divided into two groups: group I (22) patients with normal NTpro
BNP (<300 pg/ml), and group II (42) patients with elevated NT-pro BNP. Group II
had higher incidence of heart failure (28.6% vs. 4.6% P=0.025), impaired kidney function
(creatinine 1.7±0.6 vs. 1.1±0.2, P=0.018) and cardiogenic shock (26.2% vs. 0% P=0.014)
but lower incidence of chest pain (21.4% vs. 45.5% P=0.04) and lower LV ejection fraction
(51.3%±16.9% vs. 67.3%±12.8% P=0.043) compared to group I. Group II had higher
treatment with thrombolytic therapy (35.7% vs. 9.1%, P= 0.021) and positive inotropic
(35.71% vs. 4.55%, P=0.006), higher need for mechanical ventilation (26.2% vs. 4.55%,
P=0.04), longer hospital stay (19.5±10.3 vs. 5.3±4.5, p=0.001) and higher mortality (19.05%
vs. 0.0% P=0.042) than group I.
Conclusion: Elevated NT-pro BNP levels in patients with PE are associated with worse short term prognosis in terms of higher
morbidity and mortality and it could be used as a valuable prognostic parameter and good indicator for the need of more
1. S. Z. Glodhabber, “Pulmonary Embolism. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine,” 9th
Edition, Saunders, 2012.
2. H. Dores, C. Fonseca, S. Leal, I. Rosário, J. Abecasis, J. Monge, M. J. Correia, L. Bronze, A. Leitão, I. Arroja, A. Aleixo and
A. Silva, “NT-pro BNP for Risk Stratification of Pulmonary Embolism,” Portuguese Journal of Cardi-ology, Vol. 30, No.
12, 2011, pp. 881-886.
3. M. J. Agterof, R. E. Schutgens, R. J. Snijder, G. Epping,G. Peltenburg, E. F. Posthuma, J. A. Hardeman, R. vander Griend, T.
Koster, M. H. Prins and D. H. Biesma, “Out of Hospital Treatment of Acute Pulmonary Embo-lism in Patients with a Low
NT-pro BNP Level,” Journal of Thromb Haemost, Vol. 8, No. 6, 2010, pp. 1235-1241. doi:10.1111/j.1538-7836.2010.03831.x
4. R. Cavallazzi, A. Nair, T. Vasu and P. E. Marik, “Natriuretic Peptides in Acute Pulmonary Embolism: A Systematic Review
Published Online,” Vol. 34, No. 12, 2008, pp. 2147-2156
5. N. Vuilleumier, M. Righini, A. Perrier, A. Rosset, N. Turck, J. C. Sanchez, H. Bounameaux, G. Le Gal, N. Mensi and D.
Hochstrasser, “Correlation between Cardiac Biomarkers and Right Ventricular Enlargement on Chest CT in Non Massive
Pulmonary Embolism,” Thombo Re-search, Vol. 121, No. 5, 2008, pp. 617-624. doi:10.1016/j.thromres.2007.07.003
Abdelaziz Gomaa is a Consultant Interventional Cardiologist at Dallah Hospital Riyadh, KSA and a Lecturer of Cardiology at Zagazig University, Egypt. He is pursuing certified level II training in Cardiac CT (Harefield-London Cardiac CT course) in addition to interventional cardiology practice. His work in Clinical Cardiology gave him good overview of different cardiology emergencies and urgencies.