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May 14, 2004HeartOpen Access

Increased cardiac troponin I on admission predicts in-hospital mortality in acute pulmonary embolism

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Why the study?

Does increased cardiac troponin I on admission predict in-hospital mortality in patients with acute pulmonary embolism?

Population

48 consecutive patients admitted to the coronary care unit with acute pulmonary embolism (PE)

Comparison

Increased cardiac troponin I on admission vs No increased cardiac troponin I on admission

Design

Cohort

Follow-up

in-hospital

Authors

LVLuigi La VecchiaHenry Ford Health System

Discussion

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Member takes

Overview

May inform risk stratification in acute PE; leaves open whether troponin-guided strategies improve outcomes.

Key Points

  • To investigate the prevalence of elevated cardiac troponin I upon hospital admission in patients with acute pulmonary embolism and assess its correlation with clinical severity and in-hospital mortality.
  • Prospectively enrolled 48 consecutive patients admitted to the coronary care unit with acute pulmonary embolism between January 2000 and December 2001.
  • Determined sequential cardiac troponin I (cTnI) levels, using a prospectively defined cutoff of >0.6 ng/ml to categorize elevated versus non-elevated groups.
  • Evaluated clinical presentation, computed tomography findings, and the primary endpoint of in-hospital mortality.
  • Elevated admission cTnI (>0.6 ng/ml) occurred in 29% of patients (14 of 48) and was associated with lower oxygen saturation (86% vs 93%, p < 0.0001) and more frequent main pulmonary artery involvement (100% vs 60%, p = 0.022).
  • In-hospital mortality was 36% (5 of 14) in patients with elevated cTnI >0.6 ng/ml compared with 3% (1 of 42) in patients with lower concentrations (p = 0.008).
  • Increased cTnI >0.6 ng/ml on admission was the strongest independent predictor of in-hospital mortality (p = 0.046).

Structured PICO

Does increased cardiac troponin I on admission predict in-hospital mortality in patients with acute pulmonary embolism?

P
Population
48 consecutive patients admitted to the coronary care unit with acute pulmonary embolism (PE)
I
Intervention
Increased cardiac troponin I (cTnI) on admission (> 0.6 ng/ml)
C
Comparator
No increased cardiac troponin I on admission (≤ 0.6 ng/ml)
O
Outcome
In-hospital mortalityhard clinical

Elevated cardiac troponin I (>0.6 ng/ml) on admission is a strong independent predictor of in-hospital mortality in patients with acute pulmonary embolism.

Cite This Study

Luigi La Vecchia (2004) studied this question.

synapsesocial.com/papers/6a819789ac3bbfe76d60edcehttps://doi.org/10.1136/hrt.2003.019745

Topics

Pulmonary embolism
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Importance of Cardiac Troponins I and T in Risk Stratification of Patients With Acute Pulmonary Embolism2002 · 450 citations
  2. 2Release Kinetics of Cardiac Troponin T in Survivors of Confirmed Severe Pulmonary Embolism2002 · 120 citations
  3. 3Elevated Cardiac Troponin Levels in Patients With Submassive Pulmonary Embolism2002 · 125 citations
  4. 4Cardiac troponin I elevation in acute pulmonary embolism is associated with right ventricular dysfunction2000 · 321 citations
  5. 5Ability of Minor Elevations of Troponins I and T to Predict Benefit From an Early Invasive Strategy in Patients With Unstable Angina and Non-ST Elevation Myocardial Infarction&lt;SUBTITLE&gt;Results From a Randomized Trial&lt;/SUBTITLE&gt;2001 · 660 citations