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The Prognostic Value of Cardiac Troponin in Acute Pulmonary Embolism FREE TO VIEW

Sherif Alsayed, MD
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New Jeddah Clinic Hospital, Jeddah, Saudi Arabia

Chest. 2011;140(4_MeetingAbstracts):594A. doi:10.1378/chest.1112163
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PURPOSE: The aim of this study is to determine the incidence of CTNT elevation and its prognostic implications in patients with confirmed pulmonary embolism (PE)

METHODS: Thirty four patients with confirmed PE were enrolled in this study. Pulmonary embolism confirmed by pulmonary angiography, ventilation perfusion lung scan, or Echocardiography and subsidiary analysis. Severity of PE was assessed by clinical scoring system. Cardiac Troponin T was measured within 12 hours after admission.

RESULTS: CTNT was elevated in 11(32%) of patients with massive and moderate PE but not with small PE. The in- hospital death (36.3% versus 4.3%), prolonged hypotension (36.4% versus 17.4%), carcinogenic shock (27.3% versus 0%), the need for resuscitation (9.1% versus 0%) mechanical ventilation (36.4% versus 4.3%) and catecholamine administration (45.5% Vs 4.3%) were significantly higher in patients with elevated Troponin T compared to those with normal Troponin T. Also hypoxemia, sinus tachycardia, RBBB, S1Q3T3 and right ventricular (R.V) dysfunction were significantly higher in patients with elevated CTNT.

CONCLUSIONS: CTNT may improve risk stratification in patients with PE and may help in identification of patient in whom more aggressive therapy may be warranted.

CLINICAL IMPLICATIONS: cardiac Troponin T (CTNT) is highly sensitive and specific marker allowing detection of minor myocardial cell damage

DISCLOSURE: The following authors have nothing to disclose: Sherif Alsayed

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