Prognosis of patients with acute pulmonary embolism and discordant right ventricle strain serum biomarkers
Autor: | Rodolfo Pizarro, Juan Ignacio Damonte, Daniel Berrocal, Juan Guido Chiabrando, Maria F. Duckwen, Ignacio M. Seropian, Ana Halsband, Ignacio Bluro |
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Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
medicine.drug_class Heart Ventricles medicine.medical_treatment Troponin T Internal medicine Natriuretic Peptide Brain Heart rate Natriuretic peptide Humans Medicine Survival analysis Aged Retrospective Studies Mechanical ventilation biology business.industry Prognosis medicine.disease Troponin Peptide Fragments Pulmonary embolism Log-rank test Cardiology biology.protein Pulmonary Embolism Cardiology and Cardiovascular Medicine business Body mass index Biomarkers |
Zdroj: | International Journal of Cardiology. 340:88-93 |
ISSN: | 0167-5273 |
Popis: | Background Right ventricle strain serum biomarkers, such as high-sensitivity cardiac troponin T (hs-cTnT) and NT-pro-brain natriuretic peptide (NT-proBNP), are prognostic in patients with pulmonary embolism (PE). Prognosis accuracy in patients with discordancy between serum biomarkers remains, however, unknown. Methods We performed a retrospective analysis in patients with intermediate or high risk PE and discordant serum biomarkers of RV strain as follows: high hs-cTnT and low NT-proBNP (‘high troponin discordance’), compared to patients with low hs-cTnT and high NT-proBNP (‘high NT-proBNP discordance’). Cut-off values for high hs-cTnT were ≥14 pg/mL in patients 75-year. Cut-off values for high NT-proBNP were ≥600 pg/mL. The primary end-point was a composite of death, resuscitated cardiac arrest, mechanical ventilation, and inotrope use at one month. ‘High troponin discordance’, age, sex and body mass index (BMI) were included in a logistic regression model. Time to event analysis was performed using Kaplan Meier curves and Log-rank test. Results 73 patients were included. ‘High troponin discordance’ patients (n=41) were younger, presented with a higher heart rate, more frequent bilateral PE, and received more thrombolytics as treatment compared with ‘high NT-proBNP discordance’ patients (n = 32). Primary end-point was significantly higher in the ‘high troponin discordance’ patients (29.3% vs 9.4%, p=0.045). ‘High troponin discordance’ was independently associated with the primary end-point after adjusting for age, sex and BMI. Log rank test confirmed worse outcome in the high troponin discordance group (p=0.037). Conclusions High troponin discordance’ patients with intermediate/high risk PE, had worse outcomes than patients with high BNP discordance. |
Databáze: | OpenAIRE |
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