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Article

Predictive value of high-sensitivity troponin I and D-dimer assays for adverse outcome in patients with acute pulmonary embolism

  • Authors:
    • Thomas Walter
    • Paul Apfaltrer
    • Frank Weilbacher
    • Mathias Meyer
    • Stefan O. Schoenberg
    • Christian Fink
    • Joachim Gruettner
  • View Affiliations / Copyright

    Affiliations: Emergency Department, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim D-68167, Germany, Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim D-68167, Germany
  • Pages: 586-590
    |
    Published online on: November 22, 2012
       https://doi.org/10.3892/etm.2012.825
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Abstract

High-sensitivity troponin (hs-cTn) assays enable the troponin cutoff value to be lowered, resulting in an increase of sensitivity at the cost of specificity. In the present study, the risk of a short‑term adverse outcome was assessed in patients with acute pulmonary embolism (PE) using high‑sensitivity troponin I (hs-cTnI). We used a cutoff value of 0.1 ng/ml in accordance with current guidelines for unstable angina (UA)/non-ST-segment elevation myocardial infarction (NSTEMI), although the detection limit of the troponin assay is lower. In addition, the risk of an adverse outcome in patients with acute PE was investigated with respect to initial D-dimer serum concentrations. In 65 patients with confirmed acute PE, hs-cTnI and D-dimer values were measured. Adverse clinical outcome was defined as cardiogenic shock, cardiopulmonary resuscitation, mechanical ventilation, vasopressor therapy, thrombolysis, catheter intervention or mortality within 60 days of PE. Patients with acute PE and serum hs-cTnI values >0.1 ng/ml showed significantly higher D-dimer concentrations (P=0.0467) and a 5-fold increased risk of an adverse clinical outcome [odds ratio (OR), 4.9; 95% confidence interval (CI), 1.28-18.66; P=0.0235] compared with patients with acute PE and hs-cTnI values <0.1 ng/ml. In patients with acute PE suffering from adverse clinical outcome, D-dimer concentrations were significantly elevated compared with those in patients with acute PE without adverse clinical outcome (P=0.02). In patients with acute PE, a hs-cTnI cutoff value of 0.1 ng/ml, which is identical to the recommended cutoff value of NSTEMI, may identify patients with a 5-fold increased risk of a short-term adverse outcome. D-dimer values are significantly higher in PE patients with elevated hs-cTnI values as well as in patients with an adverse outcome.
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Copy and paste a formatted citation
Spandidos Publications style
Walter T, Apfaltrer P, Weilbacher F, Meyer M, Schoenberg SO, Fink C and Gruettner J: Predictive value of high-sensitivity troponin I and D-dimer assays for adverse outcome in patients with acute pulmonary embolism. Exp Ther Med 5: 586-590, 2013.
APA
Walter, T., Apfaltrer, P., Weilbacher, F., Meyer, M., Schoenberg, S.O., Fink, C., & Gruettner, J. (2013). Predictive value of high-sensitivity troponin I and D-dimer assays for adverse outcome in patients with acute pulmonary embolism. Experimental and Therapeutic Medicine, 5, 586-590. https://doi.org/10.3892/etm.2012.825
MLA
Walter, T., Apfaltrer, P., Weilbacher, F., Meyer, M., Schoenberg, S. O., Fink, C., Gruettner, J."Predictive value of high-sensitivity troponin I and D-dimer assays for adverse outcome in patients with acute pulmonary embolism". Experimental and Therapeutic Medicine 5.2 (2013): 586-590.
Chicago
Walter, T., Apfaltrer, P., Weilbacher, F., Meyer, M., Schoenberg, S. O., Fink, C., Gruettner, J."Predictive value of high-sensitivity troponin I and D-dimer assays for adverse outcome in patients with acute pulmonary embolism". Experimental and Therapeutic Medicine 5, no. 2 (2013): 586-590. https://doi.org/10.3892/etm.2012.825
Copy and paste a formatted citation
x
Spandidos Publications style
Walter T, Apfaltrer P, Weilbacher F, Meyer M, Schoenberg SO, Fink C and Gruettner J: Predictive value of high-sensitivity troponin I and D-dimer assays for adverse outcome in patients with acute pulmonary embolism. Exp Ther Med 5: 586-590, 2013.
APA
Walter, T., Apfaltrer, P., Weilbacher, F., Meyer, M., Schoenberg, S.O., Fink, C., & Gruettner, J. (2013). Predictive value of high-sensitivity troponin I and D-dimer assays for adverse outcome in patients with acute pulmonary embolism. Experimental and Therapeutic Medicine, 5, 586-590. https://doi.org/10.3892/etm.2012.825
MLA
Walter, T., Apfaltrer, P., Weilbacher, F., Meyer, M., Schoenberg, S. O., Fink, C., Gruettner, J."Predictive value of high-sensitivity troponin I and D-dimer assays for adverse outcome in patients with acute pulmonary embolism". Experimental and Therapeutic Medicine 5.2 (2013): 586-590.
Chicago
Walter, T., Apfaltrer, P., Weilbacher, F., Meyer, M., Schoenberg, S. O., Fink, C., Gruettner, J."Predictive value of high-sensitivity troponin I and D-dimer assays for adverse outcome in patients with acute pulmonary embolism". Experimental and Therapeutic Medicine 5, no. 2 (2013): 586-590. https://doi.org/10.3892/etm.2012.825
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