Figures
- Fig. 1—
Flow diagram of patients assessed for study eligibility. PE: pulmonary embolism; cTnI: cardiac toponin I. #: defined as having cardiogenic shock, systolic blood pressure <90 mmHg or the need for inotropic support despite blood pressure measurements.
- Fig. 2—
Kaplan–Meier 30-day all-cause mortality of cardiac troponin I (cTnI)-positive (----) and -negative (·····) test groups. The numbers of patients at risk in the cTnI-positive group were 102, 96, 95, 93, 93, 93 and 93, while in the cTnI-negative group they were 216, 216, 214, 211, 207, 205 and 202 for day 0, 5, 10, 15, 20, 25 and 30, respectively.
- Fig. 3—
Kaplan–Meier 30-day pulmonary embolism-related mortality of cardiac troponin I (cTnI)-positive (----) and -negative (·····) test groups. The numbers of patients at risk in the cTnI-positive group were 102, 96, 95, 94, 94, 94 and 94, while in the cTnI-negative group they were 216, 216, 215, 213, 213, 213 and 212 for day 0, 5, 10, 15, 20, 25 and 30, respectively.
Tables
- Table 1—
Baseline characteristics of 318 consecutive patients with acute pulmonary embolism
Group OR (95% CI) p-value cTnI-positive cTnI-negative Subjects n 102 216 Clinical characteristics Age >65 yrs 86 (84) 154 (71) 2.2 (1.2–4.0) 0.02 Male 44 (43) 92 (43) 1.0 (0.6–1.6) 0.90 Risk factors for venous thromboembolism Cancer 18 (18) 30 (14) 1.3 (0.7–2.5) 0.45 Surgery 10 (10) 17 (8) 1.5 (0.6–2.9) 0.70 Immobility for ≥4 days 19 (19) 32 (15) 1.3 (0.7–2.5) 0.46 Previous venous thromboembolism 12 (12) 25 (12) 1.0 (0.5–2.1) 0.86 Comorbid diseases Chronic lung disease 14 (14) 39 (18) 0.7 (0.4–1.3) 0.47 Congestive heart failure 19 (19) 26 (12) 1.7 (0.9–3.2) 0.14 Clinical presentation at admission Syncope 34 (34) 25 (12) 3.8 (2.1–6.9) <0.0001 Chest pain 43 (43) 127 (59) 0.5 (0.3–0.8) 0.01 Dyspnoea 77 (77) 155 (72) 1.2 (0.7–2.1) 0.42 Cardiac frequency ≥100 beats·min−1 50 (50) 79 (37) 1.7 (1.0–2.7) 0.04 PO2 <60 mmHg 52 (52) 120 (56) 0.8 (0.5–1.3) 0.59 Systolic blood pressure <120 mmHg 37 (36) 71 (33) 1.2 (0.7–1.9) 0.69 ECG SI-QIII pattern 16 (16) 19 (9) 1.9 (0.9–3.9) 0.09 Complete/incomplete right bundle branch block 23 (23) 24 (11) 2.3 (1.2–4.4) 0.008 Inverted T-waves in V1 through V3 18 (18) 25 (12) 1.6 (0.8–3.2) 0.20 Data are presented as n (%), unless otherwise stated. OR: odds ratio; CI: confidence interval; PO2: partial pressure of oxygen.
- Table 2—
Risk factors for 30-day all-cause mortality
Nonsurvivors Survivors OR (95%CI) p-value Subjects n 23 295 Clinical characteristics Age >65 yrs 22 (96) 218 (74) 7.8 (1.0–58.6) 0.03 Male 10 (43) 126 (43) 1.0 (0.4–2.4) 0.83 Risk factors for venous thromboembolism Cancer 6 (26) 42 (14) 2.1 (0.8–5.7) 0.21 Surgery 1 (4) 26 (9) 0.5 (0.1–3.6) 0.66 Immobility for ≥4 days 7 (30) 44 (15) 2.5 (1.0–6.4) 0.11 Previous venous thromboembolism 2 (9) 35 (12) 0.7 (0.2–3.1) 0.92 Underlying diseases Chronic lung disease 4 (17) 49 (17) 1.1 (0.3–3.2) 0.77 Congestive heart failure 3 (13) 42 (14) 0.9 (0.3–3.2) 0.86 Clinical presentation at admission Syncope 2 (9) 57 (19) 0.4 (0.1–1.7) 0.36 Chest pain 9 (39) 161 (55) 0.5 (0.2–1.3) 0.20 Dyspnoea 17 (74) 215 (73) 1.0 (0.4–2.8) 0.89 Cardiac frequency ≥100 beats·min−1 9 (39) 120 (41) 0.9 (0.4–2.2) 0.97 PO2 <60 mmHg 14 (61) 158 (54) 1.3 (0.6–3.2) 0.66 Systolic blood pressure <120 mmHg 14 (61) 94 (32) 3.3 (1.4–8.0) 0.009 PESI high-risk strata# 22 (96) 196 (66) 11.1 (1.5–83.6) 0.006 Electrocardiogram SI-QIII pattern 0 (0) 35 (12) 0.16 Complete/incomplete right bundle branch block 1 (4) 46 (16) 0.2 (0–1.9) 0.21 Inverted T-waves in V1 through V3 3 (13) 40 (14) 1.0 (0.3–3.4) 0.86 Laboratory findings cTnI >0.1 ng·mL−1 9 (39) 93 (32) 1.4 (0.6–3.3) 0.65 Data are presented as n (%), unless otherwise stated. OR: odds ratio; CI: confidence interval; PO2: partial pressure of oxygen; PESI: pulmonary embolism severity index; cTnI: cardiac troponin I. #: strata defined in 17.
- Table 3—
Risk factors for fatal pulmonary embolism(PE) during 30-days of follow-up
Fatal PE Non-fatal PE OR (95% CI) p-value Subjects n 12 306 Clinical characteristics Age >65 yrs 12 (100) 228 (74) 0.09 Male 5 (42) 131 (43) 0.9 (0.3–3.1) 0.82 Risk factors for venous thromboembolism Cancer 4 (33) 44 (14) 3.0 (0.9–10.3) 0.16 Surgery 1 (8) 26 (8) 1.0 (0.1–7.9) 0.58 Immobility for ≥4 days 3 (25) 48 (16) 1.8 (0.5–6.9) 0.67 Previous venous thromboembolism 2 (17) 35 (11) 1.5 (0.3–7.4) 0.86 Underlying diseases Chronic lung disease 4 (33) 49 (16) 2.6 (0.8–9.0) 0.25 Congestive heart failure 3 (25) 42 (14) 2.1 (0.5–8.0) 0.52 Clinical presentation at admission Syncope 2 (17) 57 (19) 0.9 (0.2–4.1) 0.84 Chest pain 6 (50) 164 (54) 0.9 (0.3–2.7) 0.98 Dyspnoea 8 (67) 224 (73) 0.7 (0.2–2.5) 0.89 Cardiac frequency ≥100 beats·min−1 5 (42) 124 (40) 1.0 (0.3–3.4) 0.87 PO2 <60 mmHg 7 (58) 165 (54) 1.2 (0.4–3.8) 0.98 Systolic blood pressure <120 mmHg 6 (50) 102 (33) 2.0 (0.6–6.4) 0.36 PESI high-risk strata# 12 (100) 206 (67) 0.03 Electrocardiogram SI-QIII pattern 0 (0) 35 (11) 0.46 Complete/incomplete right bundle branch block 1 (8) 46 (15) 0.5 (0.1–4.1) 0.79 Inverted T-waves in V1 through V3 1 (8) 42 (14) 0.6 (0.1–4.5) 0.87 Laboratory findings, cTnI >0.1 ng·mL−1 8 (67) 94 (31) 4.5 (1.3–15.3) 0.02 Data are presented as n (%), unless otherwise stated. OR: odds ratio; CI: confidence interval; PO2: partial pressure of oxygen; PESI: PE severity index; cTnI: cardiac troponin I. #: strata defined in 17.
