High levels of cardiac troponin I (>1.5 ng/mL) or T (>0.1 ng/mL) in acute pulmonary embolism significantly increased mortality risk (P=0.019 and P=0.038, respectively) and in-hospital complications.
Observational (n=106)
p-value: P=0.019
BACKGROUND: Assessment of risk and appropriate management of patients with acute pulmonary embolism (PE) remains a challenge. Cardiac troponins I (cTnI) and T (cTnT) are reliable indicators of myocardial injury and may be associated with right ventricular dysfunction in PE. METHODS AND RESULTS: The present prospective study included 106 consecutive patients with confirmed acute PE. cTnI was elevated (> or =0.07 ng/mL) in 43 patients (41%), and cTnT (> or =0.04 ng/mL) was elevated in 39 (37%). Elevation of cTnI or cTnT was significantly associated with echocardiographically detected right ventricular dysfunction (P=0.001 and P1.5; cTnT >0.1 ng/mL) were compared with those with only moderately elevated levels (cTnI, 0.07 to 1.5; cTnT, 0.04 to 0.1 ng/mL). Logistic regression analysis confirmed that the mortality risk (OR) was significantly elevated only in patients with high cTnI (P=0.019) or cTnT (P=0.038) levels. Furthermore, the risk of a complicated in-hospital course was almost 5 times higher (15.47 versus 3.16) in the high-cTnI group compared with patients with moderate cTnI elevation. CONCLUSIONS: Our results indicate that cTnI and cTnT may be a novel, particularly useful tool for optimizing the management strategy in patients with acute PE.
Konstantinides et al. (Tue,) conducted a observational in Acute pulmonary embolism (n=106). Cardiac troponins I and T assessment vs. Normal or moderately elevated troponin levels was evaluated on Overall mortality and complicated in-hospital course (p=P=0.019). High levels of cardiac troponin I (>1.5 ng/mL) or T (>0.1 ng/mL) in acute pulmonary embolism significantly increased mortality risk (P=0.019 and P=0.038, respectively) and in-hospital complications.