The safety and efficacy of systemic versus catheter-based therapies: application of a prognostic model by a pulmonary embolism response team

Iskandar, Jean‐Pierre; Hariri, Essa; Kanaan, Christopher; Kassis, Nicholas; Kamran, Hayaan; Sese, Denise; Wright, Colin M.; Marinescu, Mark; Cameron, Scott J.

doi:10.1007/s11239-021-02576-3

Cited by 5 publications

(3 citation statements)

References 37 publications

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“…However, the numbers of patients having systolic blood pressure lower than 100 mmHg, ventilation rate higher than 30 times/min, and body temperature < 36°C were significantly higher in the non-survivor group (51.09% vs. 73.46%, p = 0.002; 9.48% vs. 53.06%, p < 0.0001; 1.45% vs. 8.16%, p = 0.042, respectively). Concerning the biochemical parameters, glomerular filtration rate (81.31 ± 25.48 vs. 61.55 ± 24.58, p < 0.0001), plasma albumin level (3.7 ± 0.5 vs. 3.2 ± 0.6, p < 0.001), left ventricular ejection fraction (56.4 ± 4.5 vs. 53.0 ± 6.2, p < 0.001) were significantly higher; uric acid level (5.80 ± 1.91 vs. 7.06 ± 3.03, p < 0.001), PESI score (113.74 ± 44.05 vs. 175.10 ± 64.42, p < 0.0001), high-sensitivity troponin I (hs-TpI) (3 [0-51] vs. 34 , p < 0.001), CRP (5.1 [2][3][4][5][6][7][8][9][10] vs. 15.8 [4.8-24.6], p < 0.001), and CRP/Albumin ratio (1.57 ± 6.07 vs. 5.97 ± 6.83, p < 0.001) were significantly lower in the survivor group compared to non-survivors. Furthermore, right ventricle (RV) dimensions were significantly higher in the non-survivor group (34.8 ± 5.6 vs. 39.4 ± 5., p < 0.001).…”

Section: Resultsmentioning

confidence: 99%

“…Acute pulmonary embolism (PE) is one of the manifestations of venous thromboembolism and is the third most frequent acute cardiovascular event, accounting for approximately 5-10% of deaths in hospitalized patients 1,2 . However, the mortality rates change between groups according to clinical and radiological findings; in intermediate-risk PE, the expected mortality rate was 3-8% whereas in high-risk PE, as much as 25-52% 3 .…”

Section: Introductionmentioning

confidence: 99%

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The Prognostic Value of C-Reactive Protein/Albumin Ratio in Acute Pulmonary Embolism

Özcan¹,

Dönmez²,

Tuğrul³

et al. 2022

RIC

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Background: Serum C-reactive protein (CRP) to albumin ratio (CAR) has been defined as an inflammation-based prognostic marker. We evaluated the association and prognostic value of CRP/albumin ratio in patients with pulmonary embolism (PE).Methods: A total of 256 patients with acute PE who were hospitalized between March 2016 and December 2020 were retrospectively reviewed. PE severity index (PESI) was calculated. Serum levels of CRP and albumin that were obtained at the time of admission were used for calculation. CAR was evaluated for correlation with PESI, and thus, foresee the risk of death due to PE. Results: There were 186 patients eligible for inclusion. 54 patients were in intermediate, 34 patients were in high risk and 98 patients were in very high-risk group according to PESI score. In the correlation analysis, we observed moderate positive correlations between CRP/albumin ratio, troponin and PESI score (r = 0.584, p < 0.0001; r = 521, p < 0.0001, respectively). Regression analysis revealed that only CRP/albumin ratio and PESI score were independent risk factors associated with 6-month mortality of acute PE patients. The AUC for CRP/albumin ratio was 0.643, 0.751, and 0.763 for 30-day, 90-day, and 6-month mortality, respectively (95% CI: 0.550-0.737, 0.672-0.830, 0.687-0.838]. A cut-off value of 5.33 for CRP/albumin ratio was associated with 65.3% sensitivity and 65.6% specificity in predicting 6-month mortality. Conclusion:The CRP/albumin ratio, an inexpensive and easily measurable laboratory variable, may be a useful prognostic marker of PE, especially when other causes that alter serum levels are excluded from the study. (REV INVEST CLIN. [AHEAD OF PRINT]

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Prognostic Value of C-Reactive Protein/Albumin Ratio in Acute Pulmonary Embolism

Özcan¹,

Dönmez²,

Tuğrul³

et al. 2022

RIC

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“…Unfortunately, no data on the incidence of bleeding or mortality was reported in these two studies. Jara-Palomares et al and Iskandar et al reported divergent risks for major bleeding during the thrombolysis procedure: a significatively increased risk for Jara-Palomares et al (OR = 2.1, 95% CI (1.1–3.9)) and a non-significant risk for Iskandar et al (OR = 0.98, 95% CI (0.55–1.78)) [ 92 , 93 ]. The underuse of systemic thrombolysis due to the fear of provoking bleedings has led to a less accurate estimation of the risk of bleeding in cancer patients who undergo thrombolysis.…”

Section: Management Of Cancer Patients With Pementioning

confidence: 99%

Pulmonary Embolism in the Cancer Associated Thrombosis Landscape

Poénou

Dumitru

Lafaie

et al. 2022

JCM

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In cancer patients, pulmonary embolism (PE) is the second leading cause of death after the cancer itself, most likely because of difficulties in diagnosing the disease due to its nonclassical presentation. The risk of PE recurrence and possibly the case-fatality rate depends on whether the patient presents a symptomatic PE, an unsuspected PE, a subsegmental PE, or a catheter-related PE. Choosing the best therapeutic option is challenging and should consider the risk of both the recurrence of thrombosis and the occurrence of bleeding. The purpose of this review is to provide an overview of the clinical characteristics and the treatment of cancer-associated PE, which could benefit clinicians to better manage the deadliest form of thrombosis associated with cancer. After a brief presentation of the epidemiological data, we will present the current attitude towards the diagnosis and the management of cancer patients with PE. Finally, we will discuss the perspectives of how the medical community can improve the management of this severe medical condition.

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Can GRACE Risk Score Predict Mortality and the Need for Thrombolytic Treatment in Acute Pulmonary Embolism?

Dönmez,

Özcan,

Sahin

et al. 2024

The American Journal of Cardiology

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The safety and efficacy of systemic versus catheter-based therapies: application of a prognostic model by a pulmonary embolism response team

Cited by 5 publications

References 37 publications

The Prognostic Value of C-Reactive Protein/Albumin Ratio in Acute Pulmonary Embolism

The Prognostic Value of C-Reactive Protein/Albumin Ratio in Acute Pulmonary Embolism

Pulmonary Embolism in the Cancer Associated Thrombosis Landscape

Can GRACE Risk Score Predict Mortality and the Need for Thrombolytic Treatment in Acute Pulmonary Embolism?

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