Abstract 14498: Predictive Value and Optimal Cut-Off High-Sensitivity Troponin T Levels in Patients With Acute Pulmonary Embolism

Abstract

Introduction: An elevated troponin level serves as a sign of myocardial injury in cases of acute pulmonary embolism (PE) and is considered one of the factors used to assess risk and determine thrombolytic therapy. Nonetheless, high-sensitivity troponin (hsTnT) has not been extensively researched among patients with acute PE. Hypothesis: The elevation of hsTnT levels could predict adverse outcomes in acute PE. Methods: A retrospective chart review of 307 patients who were diagnosed with acute PE from July 2020 to April 2023 was conducted. All patients were confirmed by computed tomography pulmonary angiography. The 30-day adverse outcome was defined as a composite of PE-related mortality, cardiac arrest, hemodynamic collapse, and vasopressor use. Youden-index quantification was used to identify the optimal hsTnT cut-off value. The echocardiographic right ventricular dysfunction signs and electrocardiographic findings were collected at baseline examinations. Results: HsTnT values ranged from 3 to 1152 ng/L [median 33 (25 th -75 th percentile 15-78) ng/L]. Receiver operating characteristic curve analysis for the 30-day adverse outcome showed moderate significance (AUC 0.68 (95% CI 0.60-0.81) (Fig. 1). The optimal hsTnT cut-off value was 33 ng/L. Patients with hsTnT ≥ 33 ng/L were characterized by advanced age, lower blood pressure, higher creatinine, and exhibited signs of right ventricular dysfunction. The hazard ratio of hsTnT ≥ 33 ng/L for adverse outcomes was 3.69 (95% CI 1.62-8.40) (Table 1). Conclusion: We refined the predictive value of troponin in acute PE, and suggest the level hsTnT ≥ 33 ng/L as an optimal cut-off value for the prediction of the 30-day adverse outcomes.