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Péptido natriurético cerebral como predictor de resultados adversos en pacientes con embolia pulmonar
M ten Wolde1, I I Tulevski, J W M Mulder
1Department of Vascular Medicine, F4-138, Academic Medical Center, Meibergdreef 9, PO Box 22660, 1100 DD Amsterdam, The Netherlands. m.tenwolde@amc.uva.nl
Circulation
|April 23, 2003
Resumen
Los niveles de péptido natriurético (BNP) en plasma cerebral pueden predecir resultados fatales en pacientes con embolia pulmonar. Los niveles elevados de BNP (>21,7 pmol/L) indican un 17% de riesgo de muerte, mientras que los niveles más bajos sugieren una probabilidad del 99% de un resultado sin incidentes.
Área de la Ciencia:
- Cardiología Cardiología.
- Medicina Pulmonar La medicina pulmonar es el tratamiento de las enfermedades pulmonares.
- Investigación de biomarcadores Investigación de biomarcadores.
Sus antecedentes:
- La embolia pulmonar (EP) conlleva un riesgo significativo de mortalidad (2-7%) a pesar de la terapia con anticoagulantes.
- La identificación de marcadores pronósticos para la EP es crucial para la estratificación del riesgo y la gestión del paciente.
Objetivo del estudio:
- Investigar el péptido natriurético plasmático cerebral (BNP) como predictor de resultados fatales en pacientes diagnosticados con embolia pulmonar aguda.
- Evaluar la relación entre los niveles basales de BNP y los resultados clínicos en pacientes con EP.
Principales métodos:
- Un estudio en el que participaron 110 pacientes consecutivos con embolia pulmonar.
- Medición de los niveles plasmáticos de BNP en la presentación.
- Análisis de tertiles de concentración de BNP para determinar la asociación con eventos de resultado.
- Cálculo de los valores predictivos positivos y negativos para los niveles de BNP.
Principales resultados:
- Un nivel plasmático de BNP >21,7 pmol/L se asoció con un 17% de riesgo de muerte por embolia pulmonar (95% IC, 6% a 33%).
- Un valor de BNP <21.7 pmol/L demostró un alto valor predictivo negativo (99%; 95% CI, 93% a 100%) para un resultado sin incidentes.
Conclusiones:
- Los niveles plasmáticos de BNP sirven como un predictor significativo de resultados adversos en pacientes con embolia pulmonar aguda.
- Este estudio proporciona la primera evidencia que vincula los niveles plasmáticos de BNP con el pronóstico en la EP aguda.
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