Document Detail


Outcome in stable patients with acute pulmonary embolism who had right ventricular enlargement and/or elevated levels of troponin I.
MedLine Citation:
PMID:  20691316     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Normotensive patients with acute pulmonary embolism (PE) who have increased troponin levels and right ventricular (RV) dysfunction are thought to be at high risk of death, but the level of risk is unclear. We retrospectively evaluated outcome in 1,273 stable patients with PE who had echocardiographic evaluations of RV size and/or measurement of cardiac troponin I (cTnI). In-hospital all-cause mortality was higher in those with RV enlargement (8.0%, 19 of 237, vs 3.3%, 22 of 663, p = 0.003). With an increased cTnI, irrespective of RV enlargement, all-cause mortality was 8.0% (28 of 330) versus 1.9% (15 of 835) in patients with a normal cTnI (p <0.0001). In patients with an increased cTnI combined with an enlarged right ventricle, all-cause mortality was 10.2% (12 of 118) compared to 1.9% (8 of 421) in patients who had neither (p <0.0001). These data show that increased levels of cTnI and RV enlargement are associated with an adverse outcome in stable patients with acute PE. In conclusion, increased levels of cTnI in combination with RV enlargement might indicate a group who would benefit from intense monitoring and aggressive treatment if subsequently indicated. The outcomes, however, were not extreme enough to warrant routine thrombolytic therapy.
Authors:
Paul D Stein; Fadi Matta; Muhammad Janjua; Abdo Y Yaekoub; Fadel Jaweesh; Ahmed Alrifai
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  106     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-09     Completed Date:  2010-09-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  558-63     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine and Research and Advanced Studies Program, Michigan State University, East Lansing, MI, USA. steinp@trinity-health.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Biological Markers / blood
Female
Hospital Mortality
Humans
Hypertrophy, Right Ventricular / blood,  mortality,  physiopathology*,  ultrasonography
Male
Middle Aged
Pulmonary Embolism / blood,  mortality*,  physiopathology*
Retrospective Studies
Risk Assessment
Treatment Outcome
Troponin I / blood*
Ventricular Dysfunction, Right / blood,  mortality,  physiopathology*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Troponin I

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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