Myoglobin stratifies short-term risk in acute major pulmonary embolism

Comparison of Biomarkers for Predicting Disease Severity and Long-Term Respiratory Prognosis in Patients With Acute Pulmonary Embolism

“…Pruszczyk, et al reported that the serum myoglobin levels were elevated at admission in almost half of the patients with acute PE and that an elevated myoglobin level was a powerful predictor of the risk of a fatal outcome in major pulmonary embolism. 17) Kaczyñska, et al reported that measurement of the plasma level of heart-type fatty acid binding protein at admission was useful for short-term risk stratification in patients with acute PE and that it appears to be superior to troponin-T, N-terminal pro BNP, and myoglobin for the prediction of 30-day acute PE-related mortality. 18) Vuilleumier, et al reported that patients with RVD had a significant prevalence of higher stretch-related natriuretic peptides (BNP and N-terminal pro BNP) than cardiomyocyte damage-related markers (troponin-I, myoglobin and heart-type fatty acid), and that significant prevalence differences were observed only for natriuretic peptides when patients with and without RVD were compared.…”

Serum Myoglobin in Pulmonary Embolism

“…Therefore, we checked the prevalence and prognostic significance of elevated serum myoglobin levels in 46 patients with major APE. 5 Our study showed that on admission, myoglobin serum concentrations are elevated in 45% of APE patients. All 7 in-hospital deaths occurred in the group with elevated serum myoglobin, and in one fatal case, cardiac troponin T measured simultaneously was negative.…”

Thrombolysis in submassive pulmonary embolism

“…Indeed, both clinical presentation and outcome are influenced by a number of factors in addition to the anatomical extension of the obstruction of the pulmonary vasculature. Predictors of short-term adverse outcome in patients with PE have been recently proposed, including echocardiography, serum troponin and serum BNP (brain natriuretic peptide) [3][4][5]. In a study on the short-term clinical outcome in 208 patients with acute PE, patients with cardiogenic shock had a mortality of 32% while none of the patients with normal blood pressure and without echocardiographic right ventricular dysfunction died [6].…”

“…Serial assessment of troponin, B-type natriuretic peptides and myoglobin seem more promising [5][6][7]. Troponin detected in plasma at presentation or during the first days of observation of a patient with acute PE was invariably found to indicate worse in-hospital prognosis.…”

“…Though more related to stretching rather than to damage of the myocardium, it has been also reported as prognostically relevant in acute PE. Recently, the Warsaw group reported on the prognostic significance of an even more rapid responder, myoglobin [5]. Those three biochemical markers, of which the former two are widely available as point of care tests, might provide us in the near future with an improved strategy detecting the response to initial anticoagulant treatment of patients with submassive PE.…”