Prognostic value of troponins in acute nonmassive pulmonary embolism: A meta-analysis

Bajaj, Archna; Saleeb, Michael; Rathor, Parul; Sehgal, Vasudha; Kabak, Besher; Hosur, Srikanth

doi:10.1016/j.hrtlng.2015.03.007

Cited by 55 publications

(43 citation statements)

References 41 publications

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“…Elevated cardiac biomarkers have been linked with an increased risk of mortality during the acute phase of PE [14]. Furthermore, Becatinni et al published meta-analysis which supported the fact that troponin I and/or T elevations were associated with higher medical conditions and mortality even in the subgroup of low-risk and hemodynamically stable patients [15]. Nevertheless, large-scale investigations are clearly necessary to define the precise correlation of cardiac biomarkers and its association with duration of in-hospital stay for patients with an acute PE.…”

Section: Discussionmentioning

confidence: 99%

Predictors of hospital stay in normotensive acute pulmonary embolism: a retrospective pilot study

Mukhtar

Alhafidh

Khalid

et al. 2018

Journal of Community Hospital Internal Medicine Perspectives

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Introduction: The aim of our study is to determine the clinical, biochemical, and imaging factors that affect the duration of hospital stay in patients admitted with normotensive acute pulmonary embolism.Methods: This was a single-center retrospective study conducted in a community hospital in New York metropolitan area for patients admitted from October 2015 to October 2017.Results: A total of 79 patients were included, the mean age was 55.76 (SD = 17.33), 29 cases were males (37%) and 50 cases were females (63%). Among all patients, 17 cases had short length of stay (LOS) (≤2 days) and 62 cases had long LOS (>2 days). There were statistically significant differences in age (p = .041), presence of lung disease (p = .036), number of comorbidities (p = .043), and pulmonary embolism severity index (PESI) scores (original and simplified; p = .002 and .001, respectively). Logistic regression analysis showed that PESI score significantly predicted long LOS (OR 1.067, 95% CI [1.001, 1.137], p = .048). Similarly, sPESI significantly predicted long LOS (OR 0.223, 95% CI [0.050, 0.999], p = .050). Both regression models were adjusted for age, lung disease, and number of comorbidities.Conclusion: Both original and simplified PESI scores were statistically significant predictors of duration of hospital stay. Patients with multiple comorbidities or with chronic lung disease were also likely to have prolonged hospital stay. None of the cardiac biomarkers affected the duration of hospital stay, neither did the presence of right ventricular dysfunction nor treatment modality.

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Section: Discussionmentioning

confidence: 99%

Predictors of hospital stay in normotensive acute pulmonary embolism: a retrospective pilot study

Mukhtar

Alhafidh

Khalid

et al. 2018

Journal of Community Hospital Internal Medicine Perspectives

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“…Elevated plasma troponin concentrations on admission may be associated with a worse prognosis in the acute phase of PE. Cardiac troponin I or T elevation are defined as concentrations above the normal limits, and thresholds depend on the assay used; an overview of the cut-off values has been provided by a meta-analysis [194]. Of patients with acute PE, between 30 (using conventional assays) [194,195] and 60% (using high-sensitivity assays) [196,197] have elevated cardiac troponin I or T concentrations.…”

Section: Laboratory Biomarkers 531 Markers Of Myocardial Injurymentioning

confidence: 99%

“…Cardiac troponin I or T elevation are defined as concentrations above the normal limits, and thresholds depend on the assay used; an overview of the cut-off values has been provided by a meta-analysis [194]. Of patients with acute PE, between 30 (using conventional assays) [194,195] and 60% (using high-sensitivity assays) [196,197] have elevated cardiac troponin I or T concentrations. A meta-analysis showed that elevated troponin concentrations were associated with an increased risk of mortality, both in unselected patients (OR 5.2, 95% CI 3.3-8.4) and in those who were haemodynamically stable at presentation (OR 5.9, 95% CI 2.7-13.0) [195].…”

Section: Laboratory Biomarkers 531 Markers Of Myocardial Injurymentioning

confidence: 99%

2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS)

et al. 2019

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“…Повышенный уровень тропонина I (при пороговом значении >0,2 нг/мл) показал довольно низкую про-гностическую значимость (ОР осложнений 1,9), при этом полученная нами величина ОР для тропонина I оказалась несколько ниже, чем в других работах [6,7].…”

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“…В нашей работе данный биомаркер продемон-стрировал высокую прогностическую значимость (ОР 4,6; Se 86%, Sp 55%), превосходящую таковую у тропо-нина I (ОР 1,9; Se 68%, Sp 55%). Преимущества БСЖК по сравнению с тропонином и МНУП были продемон-стрированы в мета-анализах Bajaj A, et al [6,10,11].…”

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Predictors of Short Term Outcomes in High and Moderate Risk Pulmonary Thromboembolism

Кочмарева¹,

Кокорин²,

Volkova³

et al. 2017

Russ J Cardiol

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Цель. Изучить клинические, анамнестические и лабораторно-инструменталь-ные предикторы краткосрочных осложнений тромбоэмболии легочной арте-рии (ТэЛА). Материал и методы. В исследование включено 136 пациентов высокого и промежуточного риска с ТэЛА, подтвержденной по данным МсКТ. Конеч-ными точками являлись: обструктивный шок, фатальный рецидив, летальный исход, потребность в реанимационных мероприятиях, неотложном тромболи-зисе или гемодинамической поддержке. Период наблюдения составлял 30 дней. Пациенты были распределены на группы осложненного (n=44) и нео-сложненного (n=92) течения. Результаты. Предикторами неблагоприятного течения ТэЛА являлись: нали-чие хронической сердечной недостаточности II стадии (p=0,02), сахарного диабета (сД) 2 типа (p=000001), фибрилляции предсердий (p=0,001), посто-янного фактора риска ВТэ (p=0,002), синкопе (p=0,02), положительный тест на сердечный белок, связывающий жирные кислоты (сБсЖК) (p=0,00001), положительный тест на тропонин I (p=0,02), Чсс ≥110 уд./мин (p=0,002), систолическое АД ≤100 мм рт.ст. (p=0,00001), клиренс креатинина ≤70 мл/мин (p=0,0008). Методом логистической регрессии отобрана комбинация с наибо-лее высокой прогностической значимостью, включающая ЧсC ≥110 уд./мин, АД ≤100 мм рт.ст., положительный тест на сБсЖК и наличие сД. На основании коэффициентов логистической регрессии разработана предикторная шкала, названная rOCky (risk Of Complications), включающая следующие показатели: ЧсC ≥110 уд./мин (1,5 балла), АД ≤100 мм рт.ст. (2,5 балла), положительный тест на сБсЖК (2 балла), сД 2 типа (2,5 балла). Определено пороговое значе-ние для прогнозирования комбинированной конечной точки ≥2,5 (se 84%, sp 75%), обструктивного шока ≥3,5 (se 83%, sp 83%) и летального исхода в тече-ние 30 дней ≥4,5 (se 79%, sp 82%). сочетание ≥2,5 баллов по шкале rOCky и наличие эхоКГ-признаков дисфункции правого желудочка оказалось более эффективным, чем алгоритм европейского общества кардиологов (2014г) в исследуемой популяции гемодинамически стабильных пациентов в отноше-нии обструктивного шока, фатального рецидива ТэЛА, летального исхода и комбинированной конечной точки. Заключение. Разработанная предикторная шкала rOCky продемонстриро-вала высокую эффективность в отношении прогнозирования осложнений среди гемодинамически стабильных пациентов c ТэЛА и может быть рекомен-дована к дальнейшему изучению и применению в клинической практике. pREDICTORS OF SHORT TERM OUTCOMES IN HIGH AND MODERATE RISK pULMONARY THROMbOEMbOLISMKochmareva е. А. Aim. To investigate on the clinical, anamnestic and laboratory-instrumental predictors of short term outcomes development in pulmonary thromboembolism (PTe). Material and methods. To the study, 136 patients included with the high and intermediate risk PTe confirmed by multispiral computed tomography. The endpoints were obstructive shock, fatal relapse, fatal outcome, necessity of resuscitation, urgent thrombolysis and hemodynamic support. follow-up lasted for 30 days. Patients were selected to groups of complicated (n=44) and noncomplicated (n=92) course...

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Prognostic value of troponins in acute nonmassive pulmonary embolism: A meta-analysis

Cited by 55 publications

References 41 publications

Predictors of hospital stay in normotensive acute pulmonary embolism: a retrospective pilot study

Predictors of hospital stay in normotensive acute pulmonary embolism: a retrospective pilot study

2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS)

Predictors of Short Term Outcomes in High and Moderate Risk Pulmonary Thromboembolism

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