Prognostic significance of cardiac troponin I on admission for surgical treatment of acute pulmonary embolism: a single-centre experience over more than 10 years

Thielmann, Matthias; Pasa, Susanne; Wendt, Daniel; Price, Vivien; Marggraf, G.; Neuhäuser, Markus; Piotrowski, A; Jakob, Heinz

doi:10.1093/ejcts/ezs122

Cited by 12 publications

(4 citation statements)

References 25 publications

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“…In a study by Ozsu et According to ndings of our study, the mean level of RDW in the group that met the criteria for MACPE was higher than in the MACPE negative group (p-value < 0.001). In-hospital death was also signi cantly higher in these patients (p-value < 0.001) [29]. In a previous study by Ghaffari et al, RDW was reported to be related to the MACPE parameter (p-value: 0.023), which is consistent with the results of this study [30].…”

Section: Discussionsupporting

confidence: 91%

Prognostic efficacy of RDW in patients with acute pulmonary thromboembolism for in-hospital mortality and adverse events

Asbagh

Hassannezhad

Nateghian

et al. 2022

Preprint

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Introduction: Increased red cell distribution width (RDW) is linked to pulmonary thromboembolism (PTE) severity and is associated with inflammation during the acute phase of the PTE. In this study, we aimed to measure the predictive value of RDW for in-hospital mortality and major cardiopulmonary adverse events. Methods: Data from 801 patients with the diagnosis of PTE were retrospectively reviewed. We divided patients into two groups based on experiencing Major Adverse Cardiopulmonary Events (MACPE), which includes mortality, thrombolysis, mechanical ventilation, and surgical embolectomy during hospitalization. Then the collected medical records were compared between the groups. In-hospital mortality and MACPE were our primary and secondary measured outcomes, respectively. Results: Mean RDW was 14.28 ± 1.44 in the whole population and was higher in the MACPE group (P-value= 0.024). RDW with the cut-off point of 14.05% has both sensitivity and specificity of 54% (AUC=0.555, CI=0.509 - 0.601) in predicting in-hospital MACPE, but with the cut-off point of 13.75%, it has a higher performance in predicting in-hospital death (AUC=0.650, CI=0.575 – 0.726). Patients with the RDW ≥ 13.75% had a higher mortality rate than the others (P-value=0.003). RDW remained an independent risk factor for in-hospital mortality but not MACPE after conducting a multivariable analysis (P-value= 0.009, 0.397 resp.) Conclusion: the mortality caused by pulmonary embolism can be predicted using RDW as an easily accessible marker, but it performs poorly in predicting in-hospital MACPE.

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Section: Discussionsupporting

confidence: 91%

Prognostic efficacy of RDW in patients with acute pulmonary thromboembolism for in-hospital mortality and adverse events

Asbagh

Hassannezhad

Nateghian

et al. 2022

Preprint

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“…In a similar study, positive TnI was reported in 55% of patients with a definite diagnosis of acute PTE (18), which is higher than the rate obtained in this study. In another study in 2012, TnI was positive in 50% of patients (19). The reason for the lower positive TnI rate in this study is that TnI was not measured for all patients and perhaps the sensitivity of laboratory methods was lower in this study than in similar studies.…”

Section: Discussioncontrasting

confidence: 63%

Acute Pulmonary Embolism and 1-Year Outcome: An Epidemiological Study in East of Iran, 2011-2016

2019

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Background: Pulmonary thromboembolism (PTE) is a major health problem worldwide. The present study was conducted to investigate epidemiology of acute PTE and its outcomes in Birjand city, locating in South Khorasan, Iran. Methods:In this descriptive epidemiological study, 79 patients with PTE referred to Vali-Asr Hospital, Birjand, Iran were studied during 2011 -2016. In this study, demographic data, medical history, risk factors, symptoms, and information on diagnostic methods including echocardiography findings, electrocardiographic findings, treatment procedure, duration of hospitalization, and therapeutic outcomes were collected in information form for each patient. One year later, the patients were re-visited, and echocardiography was performed for all the subjects. Finally, data were analyzed by Chi-Square and Fisher's exact tests at a significant level of 0.05 using SPSS software.Results: Results showed that annual incidence of PTE was 5.7 per 100,000 people in Birjand in 2016. History of recent surgery (18.8%) followed by hospitalization, and complete bed rest for more than 3 days (15.7%) were the most common risk factors. More than 78% of patients with PTE had abnormal echocardiography, and pulmonary arterial hypertension was the most common finding. Results of statistical analysis showed that complications were not statistically significant according to age and gender of patients (P < 0.05), but complications were higher in patients with massive PTE compared to others (P = 0.01). Comparison of in-hospital complications showed a significant difference between different treatment modalities (P < 0.01). Conclusions:History of recent surgery and hospitalization were the most common predisposing factors for PTE. Therefore, necessary programs should be more vigorously pursued for prevention of PTE.

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“…Recent studies have demonstrated a prognostic value of pre-operative troponin levels for cardiovascular events in patients undergoing non-cardiac surgery [ [14] , [15] , [16] , [23] , [24] , [25] ]. In all these studies, troponin was a significant risk predictor.…”

Section: Discussionmentioning

confidence: 99%

The predictive value of high-sensitive troponin I for perioperative risk in patients undergoing gastrointestinal tumor surgery

et al. 2021

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Background: The incidence of cardiovascular events in perioperative period of gastrointestinal tumor surgery cannot be ignored, and studies have shown that level of postoperative troponin is related to the postoperative risk of non-cardiac surgery. However, the relationship between pre-operative troponin levels and perioperative risk of gastrointestinal tumor surgery is unclear. Thus, we aimed to evaluate the value of highsensitive cardiac troponin I (hs-cTnI) prior to gastrointestinal tumor surgery for perioperative risk assessment. Methods: In this retrospective cohort study, 1259 patients who underwent gastrointestinal tumor surgery and had been tested for hs-cTnI on admission within 7 days prior to surgery were retrospectively recruited from January 2018 to June 2020. The primary combined endpoint including in-hospital all-cause mortality, acute myocardial infarction, cardiac arrest or ventricular fibrillation and acute decompensated heart failure. The secondary endpoint included total hospital stay and requirement of intensive care treatment. Findings: Compared with patients with normal hs-cTnI, those with elevated hs-cTnI (> 0¢028 ng/ml) were more likely to experience the combined endpoint (28¢2% versus 2¢7%, P < 0¢001) and there was also an increasing rate of in mortality in elevated hs-cTnI group (2¢4% versus 0¢3%, P = 0¢057). The length of total hospital stay was significantly longer in patients with elevated hs-cTnI (24¢8 § 16¢3 versus 19¢5 § 7¢9, P = 0¢003) and the number of patients requiring intensive care treatment was also higher (22¢6% versus 4¢2%, P < 0¢001). The area under the ROC curve assessing hs-cTnI in predicting in-hospital mortality was 0¢787 [95% confidence interval (CI) 0¢612À0¢963, P = 0¢015] and for combined endpoint was 0¢822 [95% CI 0¢766À0¢879, P < 0¢001]. Hs-cTnI > 0¢028 ng/ml was associated with significantly higher cardiovascular event rate in patients with the revised cardiac index 1. The positive likelihood ratio of hs-cTnI (> 0¢028 ng/ ml) for predicting combined endpoint reaches 10.5 in patients with Lee index = 0. In multivariate logistic analyses, hs-cTnI was one of the best predictors for the combined endpoint [odds ratio (OR) 5¢924 (95%CI: 2¢869À12¢233), P < 0¢001]. Interpretation: Hs-cTnI provides powerful prognostic information for patients undergoing gastrointestinal tumor surgery, and therefore provides reliable prognostic information incremental to revised cardiac index.

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Prognostic significance of cardiac troponin I on admission for surgical treatment of acute pulmonary embolism: a single-centre experience over more than 10 years

Cited by 12 publications

References 25 publications

Prognostic efficacy of RDW in patients with acute pulmonary thromboembolism for in-hospital mortality and adverse events

Prognostic efficacy of RDW in patients with acute pulmonary thromboembolism for in-hospital mortality and adverse events

Acute Pulmonary Embolism and 1-Year Outcome: An Epidemiological Study in East of Iran, 2011-2016

The predictive value of high-sensitive troponin I for perioperative risk in patients undergoing gastrointestinal tumor surgery

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