Predictive value of troponins and simplified pulmonary embolism severity index in patients with normotensive pulmonary embolismReport as inadecuate




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Multidisciplinary Respiratory Medicine

, 8:34

First Online: 28 May 2013Received: 30 December 2012Accepted: 18 March 2013

Abstract

BackgroundTo investigate whether 2 cardiac troponins conventional troponin-TcTnT and high sensitive troponin-ThsTnT combined with simplified pulmonary embolism severity index sPESI, or either test alone are useful for predicting 30-day mortality and 6 months adverse outcomes in patients with normotensive pulmonary embolismPE.

MethodsThe prospective study included 121 consecutive patients with normotensive PE confirmed by computerized tomographicCT pulmonary angiography. The primary end point of the study was the 30-day all-cause mortality. The secondary end point included the 180-day all-cause mortality, the nonfatal symptomatic recurrent PE, or the nonfatal major bleeding.

ResultsOverall, 16 13.2% out of 121 patients died during the first month of follow up. The predefined hsTnT cutoff value of 0.014 ng-mL combined with a sPESI ≥1 -points were the most significant predictor for 30-day mortality OR: 27.6 95% CI: 3.5–217 in the univariate analysis. Alone, sPESI ≥1 points had the highest negative predictive value for both 30-day all-cause mortality and 6-months adverse outcomes,100% and 91% respectively.

ConclusionsThe hsTnT assay combined with the sPESI may provide better predictive information than the cTnT assay for early death of PE patients. Low sPESI 0 points may be used for identifying the outpatient treatment for PE patients and biomarker levels seem to be unnecessary for risk stratification in these patients.

KeywordsPrognosis Pulmonary embolism Risk scores Troponins Electronic supplementary materialThe online version of this article doi:10.1186-2049-6958-8-34 contains supplementary material, which is available to authorized users.

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Author: Savas Ozsu - Yasin Abul - Asim Orem - Funda Oztuna - Yilmaz Bulbul - Huseyin Yaman - Tevfik Ozlu

Source: https://link.springer.com/



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