TY - JOUR T1 - Age-adjusted high-sensitivity troponin T cut-off value for risk stratification of pulmonary embolism JF - European Respiratory Journal JO - Eur Respir J SP - 1323 LP - 1331 DO - 10.1183/09031936.00174514 VL - 45 IS - 5 AU - Anja Kaeberich AU - Valerie Seeber AU - David Jiménez AU - Maciej Kostrubiec AU - Claudia Dellas AU - Gerd Hasenfuß AU - Evangelos Giannitsis AU - Piotr Pruszczyk AU - Stavros Konstantinides AU - Mareike Lankeit Y1 - 2015/05/01 UR - http://erj.ersjournals.com/content/45/5/1323.abstract N2 - High-sensitivity troponin T (hsTnT) helps in identifying pulmonary embolism patients at low risk of an adverse outcome. In 682 normotensive pulmonary embolism patients we investigate whether an optimised hsTnT cut-off value and adjustment for age improve the identification of patients at elevated risk. Overall, 25 (3.7%) patients had an adverse 30-day outcome. The established hsTnT cut-off value of 14 pg·mL−1 retained its high prognostic value (OR (95% CI) 16.64 (2.24–123.74); p=0.006) compared with the cut-off value of 33 pg·mL−1 calculated by receiver operating characteristic analysis (7.14 (2.64–19.26); p<0.001). In elderly (aged ≥75 years) patients, an age-optimised hsTnT cut-off value of 45 pg·mL−1 but not the established cut-off value of 14 pg·mL−1 predicted an adverse outcome. An age-adjusted hsTnT cut-off value (≥14 pg·mL−1 for patients aged <75 years and ≥45 pg·mL−1 for patients aged ≥75 years) provided additive and independent prognostic information on top of the simplified pulmonary embolism severity index (sPESI) and echocardiography (OR 4.56 (1.30–16.01); p=0.018, C-index=0.77). A three-step approach based on the sPESI, hsTnT and echocardiography identified 16.6% of all patients as being at higher risk (12.4% adverse outcome). Risk assessment of normotensive pulmonary embolism patients was improved by the introduction of an age-adjusted hsTnT cut-off value. A three-step approach helped identify patients at higher risk of an adverse outcome who might benefit from advanced therapy. Age-adjusted hsTnT cut-off values for risk stratification of pulmonary embolism provide additive prognostic information. http://ow.ly/FmcZl ER -