Peptides natriurétiques comme facteur pronostique dans l'embolie pulmonaire aigue : une méta-analyse
|Advisor:||Provencher, Steeve; Lacasse, Yves|
|Abstract:||Background –We performed a meta-analysis to assess the association between elevated natriuretic peptide (PN) levels alone or in conjunction with troponins, and the outcomes (mortality, adverse events, and echographic right ventricular dysfunction) in acute pulmonary embolism (EPA). Results – 23 studies were included (1127 patients). Elevated natriuretic peptide was significantly associated with all-cause mortality (OR 6.2), APE-related mortality (OR 5.0) and serious adverse events (OR 6.7). Among patients with elevated NP levels, increased serum troponins were associated with further increase in risk of adverse outcomes. The analysis of NP accuracy in detecting of right ventricular dysfunction was limited by heterogeneity across studies. BNP appeared to have better sensitivity and specificity than NT-proBNP in detection of right ventricular dysfunction. Conclusions – Elevated NP identified a subset of patients with APE at higher risk of adverse outcomes. Among patients with elevated NP levels, increased troponins were documented as an independent prognostic marker.|
|Document Type:||Mémoire de maîtrise|
|Open Access Date:||16 April 2018|
|Collection:||Thèses et mémoires|
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