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Valor pronóstico del péptido natriurético cerebral y la troponina I en el tromboembolismo pulmonar de moderado y alto riesgo;
Prognostic value of brain natriuretic peptide and troponin I in moderate and high risk pulmonary embolism

Creators:Jaimovich, Guillermo; Servicio de Cardiología, Instituto de Medicina Cardiovascular, Hospital Italiano de Buenos Aires,, Benger, Juan; Servicio de Cardiología, Instituto de Medicina Cardiovascular, Hospital Italiano de Buenos Aires,, Masson, Walter M.; Servicio de Cardiología, Instituto de Medicina Cardiovascular, Hospital Italiano de Buenos Aires,, Giacomini, Mauro L.; Servicio de Cardiología, Instituto de Medicina Cardiovascular, Hospital Italiano de Buenos Aires,, Oberti, Pablo F.; Servicio de Cardiología, Instituto de Medicina Cardiovascular, Hospital Italiano de Buenos Aires,, Navarro Estrada, José L.; Servicio de Cardiología, Instituto de Medicina Cardiovascular, Hospital Italiano de Buenos Aires,, Cagide, Arturo M.; Servicio de Cardiología, Instituto de Medicina Cardiovascular, Hospital Italiano de Buenos Aires,
2012-07-26

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Descripción

Introducción El péptido natriurético cerebral (BNP) y las troponinas son útiles para la estratificación del tromboembolismo pulmonar (TEP), pero se desconoce cual tiene mejor asociación con la gravedad del cuadro. El objetivo de este trabajo es valorarlos en forma comparativa dentro de una población de moderado y alto riesgo. Material y Métodos Se realizó un registro prospectivo de los pacientes con diagnóstico de TEP que presentaran troponina I (TI) o BNP positivos. Se realizó ecocardiograma en las primeras 24 hs y seguimiento clínico en la internación. Se estableció un punto combinado de muerte, recurrencia de TEP, shock, hipotensión arterial, asistencia respiratoria mecánica y uso de trombolíticos. Se buscó la asociación entre ambos marcadores y los eventos descriptos. Resultados Se incluyeron 71 pacientes consecutivos. Los pacientes con disfunción moderada o severa del ventrículo derecho presentaron niveles mayores de BNP 661 pg/ml (420-1113) vs. 316 pg/ml (129-570) p=0.002, sin diferencias en los niveles de TI 0.115 ng/ml (0.015-0.345) vs. 0.24 ng/ml (0.076-0.58) p=0,0788. Los niveles de BNP fueron mayores en quienes presentaron el punto combinado: 604 pg/ml (370-934) vs. 316 pg/ml (148-900) p= 0,042; mientras que con la TI no ocurrió lo mismo: 0,12 ng/ml (0.037-0.48) vs. 0,13 ng/ml (0.07-0.41) p= 0,46. Conclusiones El BNP tuvo valores más elevados en pacientes con disfunción ventricular significativa y en quienes tuvieron el punto combinado. Este hallazgo podría reflejar una mayor utilidad del BNP respecto de la TI para identificar los pacientes con mayor compromiso clínico.Rev Argent Cardiol 2012;80 doi:10.7775/rac.v80.i4.1329

Background Brain natriuretic peptide (BNP) and troponins are useful markers for risk stratification in pulmonary thromboembolism (PTE). However, it is not clear which of the two biomarkers has better association with the clinical severity of this condition. Objective The aim of this study was to assess both biomarkers in moderate and high risk populations. Methods A prospective study was undertaken to analyze all patients diagnosed with PTE who had positive troponin I (TI) or BNP levels. An echocardiogram within the first 24 hours and clinical follow up during hospitalization were performed on these patients. A composite endpoint of death, recurrent PTE, shock, hypotension, mechanical ventilation and thrombolytic therapy was established. The association of both serum markers with the described events was assessed. Results Seventy one consecutive patients were included in this study. Patients with moderate or severe right ventricular dysfunction had higher BNP levels (661 pg/ml (420-1113) vs. 316 pg/ml (129-570) p=0.002) without significant difference in TI levels (0.115 ng/ml (0.015-0.345) vs. 0.24 ng/ml (0.076-0.58) p=0.0788). BNP levels were higher in patients with composite endpoint [604 pg/ml (370-934) vs. 316 pg/ml (148-900) p=0.042], whereas no similar association was found for TI [0.12 ng/ml (0.037-0.48) vs. 0.13 ng/ml (0.07-0.41) p=0.46]. Conclusions BNP showed higher values in patients with right ventricular dysfunction and composite endpoint, indicating its greater sensitivity to identify patients with more severe clinical involvement.

Metadatos destacados

Colecciones
Argentine Journal of Cardiology

Editor

Sociedad Argentina de Cardiología

Fuente

Revista Argentina de Cardiología; Vol 80, No 4 (2012), Argentine Journal of Cardiology; Vol 80, No 4 (2012)

Citación

Jaimovich, Guillermo; Servicio de Cardiología, Instituto de Medicina Cardiovascular, Hospital Italiano de Buenos Aires, et al., “Valor pronóstico del péptido natriurético cerebral y la troponina I en el tromboembolismo pulmonar de moderado y alto riesgo,” Archivo PPCT, consulta 2 de abril de 2026, http://archivoppct.caicyt.gov.ar/items/show/8114.

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Materia

Autor

Jaimovich, Guillermo; Servicio de Cardiología, Instituto de Medicina Cardiovascular, Hospital Italiano de Buenos Aires,
Benger, Juan; Servicio de Cardiología, Instituto de Medicina Cardiovascular, Hospital Italiano de Buenos Aires,
Masson, Walter M.; Servicio de Cardiología, Instituto de Medicina Cardiovascular, Hospital Italiano de Buenos Aires,
Giacomini, Mauro L.; Servicio de Cardiología, Instituto de Medicina Cardiovascular, Hospital Italiano de Buenos Aires,
Oberti, Pablo F.; Servicio de Cardiología, Instituto de Medicina Cardiovascular, Hospital Italiano de Buenos Aires,
Navarro Estrada, José L.; Servicio de Cardiología, Instituto de Medicina Cardiovascular, Hospital Italiano de Buenos Aires,
Cagide, Arturo M.; Servicio de Cardiología, Instituto de Medicina Cardiovascular, Hospital Italiano de Buenos Aires,

Fuente

Revista Argentina de Cardiología; Vol 80, No 4 (2012)
Argentine Journal of Cardiology; Vol 80, No 4 (2012)

Editor

Sociedad Argentina de Cardiología

Fecha

2012-07-26

Derechos

Los que firman al pié, certificamos que tenemos total responsabilidad por la conducción de este estudio y por el diseño y la interpretación de los datos. Nosotros escribimos el manuscrito y somos responsables por la decisión acerca del mismo. Cada uno de nosotros cumple la definición de autor como se afirma en el Comité Internacional de Editores de Revistas Médicas (International Committee of Medical Journal Editors, ver www.icmje.org). Nosotros hemos visto y aprobado el manuscrito final. Ni el artículo, ni ninguna parte esencial del mismo, incluido las tablas y las figuras, será publicado o admitido para arbitrar a otra parte antes de aparecer en la Revista.También notificamos haber leído la sección “conflicto de intereses”, y revelaríamos cualquiera que existiera. Dejamos constancia que si nuestro artículo se publicara en la RAC, cederíamos los derechos (copyright) a la Revista.Los documentos publicados en esta revista están bajo la licencia Creative Commons Atribución-NoComercial-Compartir-Igual 2.5 Argentina.
Those signing below certify that we have full responsibility for the conduction of this study and for the design and interpretation of the information. We wrote the manuscript and are responsible for its decision. Each of us fulfills the definition of authorship as stated by the International Committee of Medical Journal Editors ( www.icmje.org). We have signed and approved the final manuscript. Neither the manuscript, nor any essential part thereof, including tables and figures, will be published or accepted for refereeing elsewhere before being published in the Journal. We have also read the "Conflict of Interest" section and would disclose any existing. We state that if our manuscript is published in the RAC, we shall transfer the copyright to the Journal.

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spa
eng

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info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion