Chest
Clinical InvestigationsClotsCardiac Troponin T Monitoring Identifies High-Risk Group of Normotensive Patients With Acute Pulmonary Embolisma
Section snippets
Clinical Data
The study analyzed normotensive patients with acute PE. PE was confirmed by typical findings from contrast-enhanced spiral CT scanning, which was performed according to the previously described protocol13in 59 cases, or by high-probability lung scintigraphy in 5 cases according to the criteria of the Prospective Investigation of Pulmonary Embolism.14At hospital admission, systemic BP was measured with a mercury sphygmomanometer, and heart rate, 12-lead ECG, and transcutaneous pulse oximetry
Clinical Data
Before entering the study, no patient was in shock or required catecholamine infusion, no patient had undergone cardiopulmonary resuscitation, or had received ventilation. At hospital admission, the mean systolic BP for the whole group was 122.3 ± 22.4 mm Hg, varying from 90 to 170 mm Hg, with a mean heart rate of 100.1 ± 19.3 L/min.
According to the results of echocardiographic examination, the study population was characterized by an enlarged RV with mean end-diastolic RV/LV ratio of 1.03 ±
Discussion
Shock or systemic hypotension with systolic BP < 90 mm Hg are generally accepted indications for urgent thrombolysis in patients with acute PE.10Although it has been reported that the in-hospital mortality rate in a subgroup of normotensive patients with signs of RV pressure overload on echocardiography may be as high as 12.6 to 15.9%,67controversies exist about whether those patients should receive thrombolysis or anticoagulation therapy alone.11Moreover, recent French retrospective study15
Conclusion
Patients with PE and detectable plasma cTnT levels on repeat assays are at significant risk for a complicated clinical course and fatal outcome. Therefore, cTnT(+) patients with PE should be regarded as a high-risk group.
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Association of high-sensitivity cardiac troponin T with all-cause and cardiovascular mortality in older adults with low lean mass: A 14.6-year longitudinal study
2024, Archives of Gerontology and GeriatricsAn emergency medicine approach to troponin elevation due to causes other than occlusion myocardial infarction
2020, American Journal of Emergency MedicineCitation Excerpt :When compared to troponin elevation in OMI, the troponin elevation in PE is lower and persists for a shorter time period [1,5-11,109-113]. However, patients with acute PE and troponin >0.04 ng/mL demonstrate a 10-fold higher risk of adverse clinical outcome [103-106,109-115]. One meta-analysis suggests increased risk of short-term mortality from PE in those with elevated troponin [114].
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2020, Image-Guided Interventions: Expert Radiology Series, Third EditionThe ratio of N-terminal pro-B-type natriuretic peptide to troponin I for differentiating acute coronary syndrome
2019, American Journal of Emergency MedicineCitation Excerpt :Elevated troponins without coronary etiology have been described in numerous studies. Elevation of Troponins were observed in 32 to 50% of patients with pulmonary thromboembolism [8], in 32 to 49% of patients with perimyocarditis [9], 52 to 55% of patients in acute heart failure [10], and 36 to 85% of patients in sepsis [11]. Elevated TnI levels have even occurred in up to 30% of heathy athletes [12].
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Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (e-mail: [email protected]).
This study was supported by grant KBN 1398/P05/2000/19 from the State Committee for Scientific Research.