Thursday, June 11, 2009

Thursday June 11, 2009
Value of Cardiac Troponin in PE


In patients with severe pulmonary embolism (PE), myocardial ischemia may lead to progressive right ventricular dysfunction. It was therefore the purpose of this study to test prognostic implications in patients with confirmed PE.

Methods : Fifty-six consecutive patients with confirmed PE were enrolled in this prospective study. PE was confirmed by pulmonary angiography, lung scan, or echocardiography and subsidiary analyses. Severity of PE was assessed by a clinical scoring system, and cTnT was measured within 12 hours after admission.

Results:
  • cTnT was elevated in 18 (32%) patients with massive and moderate PE but not in patients with small PE.
  • In-hospital death, prolonged hypotension and cardiogenic shock, and need for resuscitation were more prevalent in patients with elevated cTnT.
  • cTnT-positive patients more often needed inotropic support and mechanical ventilation.
  • After adjustment, cTnT remained an independent predictor of 30-day mortality.

Conclusions—cTnT may improve risk stratification in patients with PE and may aid in the identification of patients in whom a more aggressive therapy may be warranted.



Reference:

1.
Independent Prognostic Value of Cardiac Troponin T in Patients With Confirmed Pulmonary Embolism (Circulation. 2000;102:211.)