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Biomarker-based risk assessment model in acute pulmonary embolism.
Eur Heart J 2005; 26(20):2166-72EH

Abstract

AIMS

Despite growing interest in biomarkers application for risk evaluation in acute pulmonary embolism (APE), no decision-making levels have been defined.

METHODS AND RESULTS

We developed a biomarker-based risk stratification in 100 consecutive, normotensive on admission, APE patients (35 males, 65 females, 62+/-18 years). On admission serum NT-proBNP and cardiac troponin T (cTnT) levels were assessed and echocardiography was performed. All-cause 40-day mortality was 15% and APE mortality was 8%. In univariable analysis, cTnT>0.07 microg/L predicted all-cause mortality, hazard ratio (HR) 9.2 (95% CI: 3.3-26.1, P<0.0001), and APE mortality, HR 18.1 (95% CI: 3.6-90.2, P=0.0004); similarly, NT-proBNP>7600 ng/L predicted all-cause and APE mortalities [HR 6.7 (95% CI: 2.4-19.0, P=0.0003) and 7.3 (95% CI: 1.7-30.6, P=0.007)]. NT-proBNP<600 ng/L indicated uncomplicated outcome. Multivariable analysis revealed that cTnT>0.07 microg/L was the most significant independent predictor, whereas NT-proBNP and systemic systolic blood pressure measured on admission and echocardiographic parameters were non-significant. APE mortality in patients with NT-proBNP> or =600 ng/L and cTnT> or =0.07 microg/L reached 33%. NT-proBNP<600 ng/L indicated group without deaths. APE mortality for patients with NT-proBNP> or =600 ng/L and cTnT<0.07 microg/L was 3.7%. Incorporation of echocardiographic data did not improve group selection.

CONCLUSION

Simultaneous measurement of serum cTnT and NT-proBNP allows for precise APE prognosis. Normotensive patients on admission with cTnT> or =0.07 microg/L and NT-proBNP> or =600 ng/L are at high risk of APE mortality, whereas NTproBNP<600 ng/L indicates excellent prognosis.

Authors+Show Affiliations

Department of Internal Medicine, Hypertension and Angiology, The Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15911566

Citation

Kostrubiec, Maciej, et al. "Biomarker-based Risk Assessment Model in Acute Pulmonary Embolism." European Heart Journal, vol. 26, no. 20, 2005, pp. 2166-72.
Kostrubiec M, Pruszczyk P, Bochowicz A, et al. Biomarker-based risk assessment model in acute pulmonary embolism. Eur Heart J. 2005;26(20):2166-72.
Kostrubiec, M., Pruszczyk, P., Bochowicz, A., Pacho, R., Szulc, M., Kaczynska, A., ... Kuczynska, K. (2005). Biomarker-based risk assessment model in acute pulmonary embolism. European Heart Journal, 26(20), pp. 2166-72.
Kostrubiec M, et al. Biomarker-based Risk Assessment Model in Acute Pulmonary Embolism. Eur Heart J. 2005;26(20):2166-72. PubMed PMID: 15911566.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Biomarker-based risk assessment model in acute pulmonary embolism. AU - Kostrubiec,Maciej, AU - Pruszczyk,Piotr, AU - Bochowicz,Anna, AU - Pacho,Ryszard, AU - Szulc,Marcin, AU - Kaczynska,Anna, AU - Styczynski,Grzegorz, AU - Kuch-Wocial,Agnieszka, AU - Abramczyk,Piotr, AU - Bartoszewicz,Zbigniew, AU - Berent,Hanna, AU - Kuczynska,Krystyna, Y1 - 2005/05/23/ PY - 2005/5/25/pubmed PY - 2006/3/22/medline PY - 2005/5/25/entrez SP - 2166 EP - 72 JF - European heart journal JO - Eur. Heart J. VL - 26 IS - 20 N2 - AIMS: Despite growing interest in biomarkers application for risk evaluation in acute pulmonary embolism (APE), no decision-making levels have been defined. METHODS AND RESULTS: We developed a biomarker-based risk stratification in 100 consecutive, normotensive on admission, APE patients (35 males, 65 females, 62+/-18 years). On admission serum NT-proBNP and cardiac troponin T (cTnT) levels were assessed and echocardiography was performed. All-cause 40-day mortality was 15% and APE mortality was 8%. In univariable analysis, cTnT>0.07 microg/L predicted all-cause mortality, hazard ratio (HR) 9.2 (95% CI: 3.3-26.1, P<0.0001), and APE mortality, HR 18.1 (95% CI: 3.6-90.2, P=0.0004); similarly, NT-proBNP>7600 ng/L predicted all-cause and APE mortalities [HR 6.7 (95% CI: 2.4-19.0, P=0.0003) and 7.3 (95% CI: 1.7-30.6, P=0.007)]. NT-proBNP<600 ng/L indicated uncomplicated outcome. Multivariable analysis revealed that cTnT>0.07 microg/L was the most significant independent predictor, whereas NT-proBNP and systemic systolic blood pressure measured on admission and echocardiographic parameters were non-significant. APE mortality in patients with NT-proBNP> or =600 ng/L and cTnT> or =0.07 microg/L reached 33%. NT-proBNP<600 ng/L indicated group without deaths. APE mortality for patients with NT-proBNP> or =600 ng/L and cTnT<0.07 microg/L was 3.7%. Incorporation of echocardiographic data did not improve group selection. CONCLUSION: Simultaneous measurement of serum cTnT and NT-proBNP allows for precise APE prognosis. Normotensive patients on admission with cTnT> or =0.07 microg/L and NT-proBNP> or =600 ng/L are at high risk of APE mortality, whereas NTproBNP<600 ng/L indicates excellent prognosis. SN - 0195-668X UR - https://www.unboundmedicine.com/medline/citation/15911566/Biomarker_based_risk_assessment_model_in_acute_pulmonary_embolism_ L2 - https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehi336 DB - PRIME DP - Unbound Medicine ER -