Troponin I and risk stratification of patients with acute non massive pulmonary embolism

¹ Respiratory Dept, Ramón y Cajal Hospital, Madrid, Spain
² Cardiology Dept, Ramón y Cajal Hospital, Madrid, Spain
³ Clinical Biochemistry Dept, Ramón y Cajal Hospital, Madrid, Spain
⁴ Divisions of Pulmonary and Critical Care Medicine and General Medical Sciences, Washington University School of Medicine, St. Louis, Missouri, USA

^* To whom correspondence should be addressed. E-mail: djc_69_98{at}yahoo.com.

	Abstract

Assessment of risk and appropriate treatment of patients with acute pulmonary embolism (PE) remains a challenge.

We prospectively assessed the prognostic performance of troponin I (cTnI) in predicting 30-day all-cause mortality in consecutive hemodynamically stable patients with PE.

The study included 318 hemodynamically stable patients with PE. During the 30-day study period, 23 patients (7%) died. cTnI was elevated (0.1 ng mL^-1) in 102 patients (32%). Age >65 years, systolic blood pressure <120 mm Hg, and severity of illness assessed using the Pulmonary Embolism Severity Index (PESI) were significantly associated with an increased risk for mortality, but no significant association was found between elevation of cTnI and 30-day mortality in the logistic regression analysis. When only fatal PE was considered, multivariate analysis showed that severity of illness using the PESI, and an elevated cTnI (OR, 3.7; 95% CI, 1.1–12.8, P=0.03) were associated with a significant increase in the risk for death. The negative predictive value of a negative cTnI for mortality was 93% (95% CI: 90–97%).

In a series of hemodynamically stable patients with acute PE, cTnI was not an independent predictor of 30-day all-cause mortality, though it predicted fatal PE.

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