
The long‐term prognostic value of highly sensitive cardiac troponin I in patients with acute pulmonary embolism
Author(s) -
Lee Chuy Katherine,
Hakemi Emad Uddin,
Alyousef Tareq,
Dang Geetanjali,
Doukky Rami
Publication year - 2017
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.22823
Subject(s) - medicine , troponin i , pulmonary embolism , troponin , retrospective cohort study , cardiology , hazard ratio , cohort , cohort study , surgery , myocardial infarction , confidence interval
Background In patients with acute pulmonary embolism (PE), detectable levels of cardiac troponin I (cTnI) using a highly sensitive assay have been associated with increased in‐hospital mortality. We sought to investigate the impact of detectable cTnI on long‐term survival following acute PE. Hypothesis Detectable cTnI levels in patients presenting with acute PE predict increased long‐term mortality following hospital discharge. Methods In a retrospective cohort study, we analyzed consecutive patients with confirmed acute PE and cTnI assay available from the index hospitalization. The detectable cTnI level was ≥0.012 ng/mL. Patients were classified into low and high clinical risk groups according to the Pulmonary Embolism Severity Index (PESI) at presentation. Subjects were followed for all‐cause mortality subsequent to hospital discharge using chart review and Social Security Death Index. Results A cohort of 289 acute PE patients (mean age 56 years, 51% men), of whom 152 (53%) had a detectable cTnI, was followed for a mean of 3.1 ± 1.8 years after hospital discharge. A total of 71 deaths were observed; 44 (29%) and 27 (20%) in the detectable and undetectable cTnI groups, respectively ( P = 0.05). Detectable cTnI was predictive of long‐term survival among low‐risk ( P = 0.009) but not high‐risk patients ( P = 0.78) who had high mortality rates irrespective of cTnI status. Conclusions In patients with acute PE, detectable cTnI is predictive of long‐term mortality, particularly among patients who were identified as low risk according to PESI score.