Abstract
Previous studies on the adverse events of acute pulmonary embolism (APE) were mostly limited to single marker, and short follow-up duration, from hospitalization to up to 30 days. We aimed to predict the long-term prognosis of patients with APE by joint assessment of D-dimer, N-Terminal Pro-Brain Natriuretic Peptide (NT-ProBNP), and troponin I (cTnI). Newly diagnosed patients of APE from January 2011 to December 2015 were recruited from three hospitals. Medical information of the patients was collected retrospectively by reviewing medical records. Adverse events (APE recurrence and all-cause mortality) of all enrolled patients were followed up via telephone. D-dimer > 0.50 mg/L, NT-ProBNP > 500 pg/mL, and cTnI > 0.40 ng/mL were defined as the abnormal. Kaplan–Meier curve was used to compare the cumulative survival rate between patients with different numbers of abnormal markers. Cox proportional hazard regression model was used to further test the association between numbers of abnormal markers and long-term prognosis of patients with APE after adjusting for potential confounding. During follow-up, APE recurrence and all-cause mortality happened in 78 (30.1%) patients. The proportion of APE recurrence and death in one abnormal marker, two abnormal markers, and three abnormal markers groups were 7.69%, 28.21%, and 64.10% respectively. Patients with three abnormal markers had the lowest survival rate than those with one or two abnormal markers (Log-rank test, P < 0.001). After adjustment, patients with two or three abnormal markers had a significantly higher risk of the total adverse event compared to those with one abnormal marker. The hazard ratios (95% confidence interval) were 6.27 (3.24, 12.12) and 10.7 (4.1, 28.0), respectively. Separate analyses for APE recurrence and all-cause death found similar results. A joint test of abnormal D-dimer, NT-ProBNP, and cTnI in APE patients could better predict the long-term risk of APE recurrence and all-cause mortality.
Highlights
Acute pulmonary embolism (APE) is one of the most frequent cardiovascular diseases which characterizes the blockage of pulmonary arterial bed by thromboemboli, usually a consequence of deep vein thrombosis (DVT)[1]
A total of 259 acute pulmonary embolism (APE) patients were included in the analysis
This study found that joint test of D-dimer, NT-proBNP, and Cardiac troponin I (cTnI) during hospitalization was able to predict long-term adverse events after discharge
Summary
Acute pulmonary embolism (APE) is one of the most frequent cardiovascular diseases which characterizes the blockage of pulmonary arterial bed by thromboemboli, usually a consequence of deep vein thrombosis (DVT)[1]. It is the most serious clinical outcome of venous thromboembolism (VTE), with a high mortality rate following myocardial infarction and cancer. These biomarkers have been reported for predicting clinical adverse events in APE p atients[3,4,5]. This study aimed to analyze the joint effect of D-dimer, NT-proBNP, and cTnI on predicting long-term adverse event risk on APE patients
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
