Combinations of prognostic tools for identification of high-risk normotensive patients with acute symptomatic pulmonary embolism (original) (raw)

Early Risk Stratification Of Patients With Acute Pulmonary Embolism: Role Of Cardiac Troponin I

abstract Background: The early assessment of risk and appropriate management of patients with acute pulmonary embolism (APE) remains a challenge. Objective: This study is planned to evaluate the prognostic significance of cardiac troponin I (cTnI) levels in predicting in-hospital haemodynamic instability, complicated clinical course and mortality in patients with APE. Patients and methods: This study included 42 patients with APE who were haemodynamically stable at the time of admission. According to the level of cTnI, the patients were divided into two groups. The first group involved patients with APE and elevated cTnI levels (cTnI positive group), it included 18 patients (42%) with a mean cTnI value of 0.39±0.23 ng/ml, a range of 0.08 – 0.9 ng/ml and a median of 0.36 ng/ml. the second group involved patients with APE and normal cTnI levels (cTnI negative group) , it included 24 patients with normal cTnI levels (<0.01 ng/ml). All patients were subjected to history taking and complete clinical examination including measurement of blood pressure, assessment of partial pressures of O 2 (PaO 2) and carbon dioxide (PaCO2), D-dimer, total creatine kinase (CK) and CK-MB isoenzyme and cardiac troponin I,. All patients were subjected to electrocardiography (ECG) and echocardiography.Pulmonary embolism was diagnosed by helical computed tomography(CT) angiography.