The assessment of risk stratification and prognostic value of cardiac troponin I in patients with acute pulmonary embolism

Abstract

Objective To investigate the assessment of risk stratification and prognostic value of cardiac troponin I (cTn I) in patients with acute pulmonary embolism (APE). Methods A total of 178 patients with APE in our hospital from January 2007 to December 2007 were collected and divided into cTn I + group (0.012 ng/ml) or higher and cTn I-group (<0.012 ng/ml) according to the initial inspection cTn I level. The pulmonary embolism severity index (PESI) was used for clinical risk determination and electrocardiography (ECG), echocardiography, imaging results, and positive and adverse were recorded. Results Among 178 consecutive patients with confirmed acute PE; 96 (53.9%) were cTnI+ and 82 (46.1%) were cTnI-. hard events cTn I+ and cTn I-71 cases (74.0%) and 0, respectively (P=0.000). soft events cTn I+ and cTn I-were 80 cases (83.3%) and 18 cases (22.0%), respectively (P=0.000). Kaplan Meier curve showed that patients in cTn I-groups had higher survival free of hard (P=0.000) or soft (P= 0.000) events, irrespective of clinical risk. Conclusions Highly sensitive cTn I assay provides an excellent prognostic negative predictive value, thus it has a role in identification of candidates for out-of-hospital treatment of acute PE. Key words: Troponin I/ME; Pulmonary embolism/ME; Risk; Prognosis