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Abstract

Introduction: Alkaline phosphatase (ALP) can be found elevated in patient with pulmonary embolism (PE). However, its role in PE is unknown. In this study, we aimed to investigate the relationship between ALP and mortality in patients with PE. Methods: Retrospective medical records review of 109 patients diagnosed with PE. The demographic data, clinical manifestation, and laboratory findings were collected and compared between patients categorized as having increased ALP (group 1) and no increased ALP (group 2) using optimal cutoff value of ALP to predict mortality was measured as more than 136 IU/L. Mortality at 1 year was also collected. Results: Of these 109 patients (mean 59.6 ± 19 years old, 42.9% male), 18 patients died after 1 year follow-up. Among these 18 patients, 7 patients were in group 1, and 11 patients were in group 2 (p=0.043). When compared between patient who died after 1 year (dead group) and lived after 1 year group (living group), level of ALP were found to be higher in dead group although there was no statistically significance (194 vs 109, p=0.057). Conclusions: From our analysis, we found that high ALP level is associated with worse outcome in acute PE. Prior studies have been shown that level of ALP was found to be elevated in pulmonary infarction. This might explain our finding in PE. Although there is no statistically significance in our studies but these might be explained by small population size. Further studies with larger population might help to confirm this finding. Our study suggests that ALP level has a potential to be used as prognostic indicator for PE.