The long-term prognostic value of highly sensitive cardiac troponin I in patients with acute pulmonary embolism. Clin Cardiol 2017 Dec;40(12):1271-1278
Date
12/16/2017Pubmed ID
29243836Pubmed Central ID
PMC6490319DOI
10.1002/clc.22823Scopus ID
2-s2.0-85037980911 (requires institutional sign-in at Scopus site) 8 CitationsAbstract
BACKGROUND: In patients with acute pulmonary embolism (PE), detectable levels of cardiac troponin I (cTnI) using a highly sensitive assay have been associated with increased in-hospital mortality. We sought to investigate the impact of detectable cTnI on long-term survival following acute PE.
HYPOTHESIS: Detectable cTnI levels in patients presenting with acute PE predict increased long-term mortality following hospital discharge.
METHODS: In a retrospective cohort study, we analyzed consecutive patients with confirmed acute PE and cTnI assay available from the index hospitalization. The detectable cTnI level was ≥0.012 ng/mL. Patients were classified into low and high clinical risk groups according to the Pulmonary Embolism Severity Index (PESI) at presentation. Subjects were followed for all-cause mortality subsequent to hospital discharge using chart review and Social Security Death Index.
RESULTS: A cohort of 289 acute PE patients (mean age 56 years, 51% men), of whom 152 (53%) had a detectable cTnI, was followed for a mean of 3.1 ± 1.8 years after hospital discharge. A total of 71 deaths were observed; 44 (29%) and 27 (20%) in the detectable and undetectable cTnI groups, respectively (P = 0.05). Detectable cTnI was predictive of long-term survival among low-risk (P = 0.009) but not high-risk patients (P = 0.78) who had high mortality rates irrespective of cTnI status.
CONCLUSIONS: In patients with acute PE, detectable cTnI is predictive of long-term mortality, particularly among patients who were identified as low risk according to PESI score.
Author List
Lee Chuy K, Hakemi EU, Alyousef T, Dang G, Doukky RMESH terms used to index this publication - Major topics in bold
Acute DiseaseComputed Tomography Angiography
Echocardiography
Electrocardiography
Female
Follow-Up Studies
Hospital Mortality
Hospitalization
Humans
Middle Aged
Predictive Value of Tests
Prognosis
Pulmonary Embolism
Retrospective Studies
Risk Assessment
Severity of Illness Index
Survival Rate
Time Factors
Troponin I
United States