| N-terminal prohormone of brain natriuretic peptide: a useful tool for the detection of acute pulmonary artery embolism in post-surgical patients. | |
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MedLine Citation:
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PMID: 22991260 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: /st>Acute pulmonary embolism (APE) is an important clinical problem in patients after major surgery and often remains a difficult diagnosis because of unspecific clinical symptoms. Therefore, we investigated the role of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) for the detection of APE. METHODS: /st>In 44 patients with suspected APE referred to the intensive care unit after major surgery, serum NT-proBNP, troponin-I, and D-dimers were measured according to the standard hospital protocol. To definitively confirm or exclude APE, all patients underwent an angiographic CT scan of the thorax. RESULTS: /st>APE was confirmed in 28 and excluded in 16 patients by CT scan. NT-proBNP was significantly (P<0.01) higher in patients with APE [4425 (sd 8826; range 63-35 000) pg ml(-1)] compared with those without [283 (sd 327; range 13-1133) pg ml(-1)]. The sensitivity of the NT-proBNP screening was 93%, specificity 63%, positive predictive value 81%, and negative predictive value 83%. There were no significant (P = 0.96) differences in D-dimers between subjects with and without APE [confirmed APE: 511 (sd 207; range 83-750) μg litre(-1); excluded APE: 509 (sd 170; range 230-750) μg litre(-1)]. Troponin-I levels were not elevated in 32% of the patients with APE. CONCLUSIONS: /st>D-dimer levels are frequently elevated in post-surgical patients and not applicable for confirmation or exclusion of APE. In contrast, NT-proBNP appears to be a useful biomarker for APE diagnosis in the postoperative setting. In the case of NT-proBNP levels below the upper reference limit, haemodynamically relevant APE is unlikely. Troponin-I in contrast is not considered to be helpful. |
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Authors:
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B E Winkler; W Schuetz; G Froeba; C-M Muth |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-9-18 |
Journal Detail:
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Title: British journal of anaesthesia Volume: - ISSN: 1471-6771 ISO Abbreviation: Br J Anaesth Publication Date: 2012 Sep |
Date Detail:
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Created Date: 2012-9-19 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372541 Medline TA: Br J Anaesth Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Anaesthesiology, University of Ulm, Prittwitzstrasse 43, 89073 Ulm, Germany. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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