Prognosis of patients with acute pulmonary embolism and discordant right ventricle strain serum biomarkers

Seropián, Ignacio M.; Chiabrando, Juan Guido; Damonte, Juan Ignacio; Halsband, Ana; Duckwen, Maria Florencia; Pizarro, Rodolfo; Berrocal, Daniel; Bluro, Ignacio

doi:10.1016/j.ijcard.2021.08.032

Cited by 5 publications

(6 citation statements)

References 21 publications

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“…Seropian et al 9 studied the impact of high cardiac troponin levels together with low NT-proBNP levels (high troponin discordance) on the outcomes of APE patients. They reported that high troponin discordance was significantly associated with the worse outcomes in these patients.…”

Section: Discussionmentioning

confidence: 99%

“…Cardiopulmonary resuscitation, hemodynamic instability (systolic blood pressure <90 mmHg or a drop in systolic blood pressure by >40 mmHg for >15 min with signs of end-organ hypoperfusion), inotrope use, recurrent or diffuse / peripheral APE, development of lower limb thrombosis, the use of mechanical ventilation within one month of admission, newly developed chest pain and dyspnea, and bleeding episode due to anticoagulant use were regarded as the adverse events. 9 APE-related death was considered in the development of death secondary to irreversible right ventricular failure or recurrence of APE. 10 All-cause mortality was also investigated.…”

Section: Methodsmentioning

confidence: 99%

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Impact of Promising Biomarkers on Severity and Outcome of Acute Pulmonary Embolism

Sağcan¹,

Doğan²,

Uzun³

et al. 2023

IJGM

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Background Acute pulmonary embolism (APE) is a common clinical condition. Its severity ranges from asymptomatic radiological findings to fatal obstructive shock. The potential circulating biomarkers have been studied to predict APE outcomes. This study aimed to explore their predictive power on prognosis in APE. Material and Method It was a prospective observational study between March 2008 and April 2010. All consecutive patients diagnosed with APE were categorized as massive/high-risk, submassive/moderate-risk, and non-massive/low-risk. Cardiac troponin T (cTnT), myoglobin, N-terminal pro-brain natriuretic peptide (NT-proBNP), heart-type fatty acid-binding protein (H-FABP), growth differentiation factor-15 (GDF-15), and D-dimer levels were measured. Results Of these patients, 14 (29.8%), 16 (34.0%), and 17 (36.2%) patients were categorized as low-risk, moderate-risk, and high risk-patients, respectively. There was no significant difference between the patient groups categorized based on the risk stratification in terms of demographic and clinical characteristics. The cTnT, myoglobin, HFABP, and D-dimer levels have also not differed significantly between the groups. There was a significant difference between the groups in respect of NT-proBNP and GDF-15 levels (p=0.009 and p=0.037, respectively). Nine (19.1%) patients had died by the 3rd-month follow-up. Adverse events were seen in 26 (55.3%) patients. GDF-15 had the highest area under the curve (AUC) value for predicting any adverse event (cut-off value=9.3 ng/mL, AUC=0.796, CI (confidence interval) 95%: 0.653–0.899). NT-ProBNP was determined as the best predictor for mortality (cut-off value=229.2 pg/mL, AUC=0.889, CI 95%: 0.756–0.964). Conclusion Higher levels of NT-proBNP and GDF-15 were found to be associated with more severe APE, worse outcomes, and mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Impact of Promising Biomarkers on Severity and Outcome of Acute Pulmonary Embolism

Sağcan¹,

Doğan²,

Uzun³

et al. 2023

IJGM

View full text Add to dashboard Cite

show abstract

“…Seropian et al [7] studied the impact of high cardiac troponin levels together with low NT-proBNP levels (high troponin discordance) on the outcomes of APE patients. They reported that high troponin discordance was signi cantly associated with the worse outcomes in these patients.…”

Section: Declarationsmentioning

confidence: 99%

“…The higher levels of these biomarkers are considered to indicate cardiac dysfunction, and thus more aggressive treatment management is recommended [4]. Nevertheless, signi cant discordances have been reported about the changes that occurred in the levels of these biomarkers [5][6][7]. Moreover, a more sensitive and speci c marker to determine the intermediate-and high-risk patients and predict the prognosis is needed in order to improve clinical outcomes [3].…”

Section: Introductionmentioning

confidence: 99%

Impact of cardiac biomarkers on severity and outcome of acute pulmonary embolism: A prospective observational study

Sağcan

Çuhadaroğlu

Okumuş

et al. 2022

Preprint

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Background Acute pulmonary embolism (APE) is a common clinical condition. Its severity ranges from asymptomatic radiological findings to fatal obstructive shock. Cardiac biomarkers have been studied to predict APE outcomes. This study aimed to explore their predictive power on prognosis in APE. Material and Method It was a prospective observational study between March 2008 and April 2010. All consecutive patients diagnosed with APE were categorized as massive/high-risk, submassive/moderate-risk, and non-massive/low-risk. Cardiac troponin T (cTnT), myoglobin, N-terminal pro-brain natriuretic peptide (NT-proBNP), heart-type fatty acid-binding protein (H-FABP), growth differentiation factor-15 (GDF-15), and D-dimer levels were measured. Results Of these patients, 14 (29.8%), 16 (34.0%), and 17 (36.2%) patients were categorized as low-risk, moderate-risk, and high risk-patients, respectively. There was no significant difference between the patient groups categorized based on the risk stratification in terms of demographic and clinical characteristics. The cTnT, myoglobin, HFABP, and D-dimer levels have also not differed significantly between the groups. There was a significant difference between the groups in respect of NT-proBNP and GDF-15 levels (p = 0.009 and p = 0.037, respectively). Nine (19.1%) patients had died by the 3rd-month follow-up. Adverse events were seen in 26 (55.3%) patients. GDF-15 had the highest area under the curve (AUC) value for predicting any adverse event (cut-off value = 9.3 ng/mL, AUC = 0.796, CI (confidence interval) 95%: 0.653–0.899). NT-ProBNP was determined as the best predictor for mortality (cut-off value = 229.2 pg/mL, AUC = 0.889, CI 95%: 0.756–0.964). Conclusion Higher levels of NT-proBNP and GDF-15 were found to be associated with more severe APE, worse outcomes, and mortality.

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“…7 However, studies on the long-term prognosis of patients with APE are also lacking. [7][8][9] In addition, the biomarkers such as troponin I, troponin T, and brain natriuretic peptide (BNP) were susceptible to the effects of previous physical activity. 10 It is still necessary to find new stable markers for the prognosis of APE.…”

Section: Introductionmentioning

confidence: 99%

The Association Between Mean Corpuscular Hemoglobin Concentration and Prognosis in Patients with Acute Pulmonary Embolism: A Retrospective Cohort Study

Ruan

et al. 2022

Clin Appl Thromb Hemost

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Introduction Acute pulmonary embolism (APE) is a typical cardiovascular emergency worldwide. Mean hemoglobin concentration (MCHC) is a standard indicator of anemia. Studies on the association between MCHC and APE are scarce. We aimed to investigate the relationship between MCHC and APE. Methods Clinical data were extracted from the Medical Information Bank for Intensive Care (MIMIC)-III. Adult (≥18 years) patients with APE admitted for the first time were included in this study. An analysis was conducted to evaluate the association between MCHC and the prognosis of patients by the Cox regression analysis, generalized additives models and Kaplan–Meier survival curves. The primary outcome was 30-day mortality, and the secondary outcomes were 1-year and 3-year mortality. Results A total of 813 patients who met the selection criteria were enrolled, of whom 130 (16.0%) died within 30 days of admission. Univariate Cox regression indicated that MCHC was significantly associated with mortality (30-day: HR = 0.74, 95% CI = 0.66–0.82, P < 0.001; 1-year: HR = 0.80, 95% CI = 0.74–0.86, P < 0.001; 3-year: HR = 0.82, 95% CI = 0.77–0.88, P < 0.001). MCHC remains stable after adjusting multiple models. Kaplan-Meier survival curves showed that patients with lower MCHC had a poorer 30-day prognosis. Conclusions Lower MCHC is an independent risk factor for increased mortality in patients with APE. As an inexpensive biomarker, MCHC should receive more attention.

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Prognosis of patients with acute pulmonary embolism and discordant right ventricle strain serum biomarkers

Cited by 5 publications

References 21 publications

Impact of Promising Biomarkers on Severity and Outcome of Acute Pulmonary Embolism

Impact of Promising Biomarkers on Severity and Outcome of Acute Pulmonary Embolism

Impact of cardiac biomarkers on severity and outcome of acute pulmonary embolism: A prospective observational study

The Association Between Mean Corpuscular Hemoglobin Concentration and Prognosis in Patients with Acute Pulmonary Embolism: A Retrospective Cohort Study

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