Open AccessImpact of cancer on the effectiveness of cardiac T roponin I to predict right ventricular dysfunction in acute pulmonary embolism
Author(s) -
Keller Karsten,
Geyer Martin,
Beule Johannes,
Coldewey Meike,
Balzer Jörn Oliver,
Dippold Wolfgang
Publication year - 2015
Publication title -
thoracic cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 28
eISSN - 1759-7714
pISSN - 1759-7706
DOI - 10.1111/1759-7714.12226
Subject(s) - medicine , receiver operating characteristic , troponin i , area under the curve , cancer , pulmonary embolism , cardiology , deep vein , thrombosis , surgery , oncology , myocardial infarction
Background Deep vein thrombosis ( DVT ) and pulmonary embolism ( PE ) are connected with a poor outcome in cancer patients. We aimed to investigate the impact of cancer on the effectiveness of cardiac T roponin I ( cTnI ) to predict right ventricular dysfunction ( RVD ) in acute PE . Methods We retrospectively analyzed the data of 182 patients with confirmed PE . PE patients were subdivided into two groups: (i) with concomitant active cancer disease or history of cancer, and (ii) without known cancer. Receiver operating characteristic (ROC) curves with area under the curve ( AUC) was calculated for cTnI predicting RVD and related cut‐off levels for both groups. Results Thirty‐seven PE patients (20.3%) had an active cancer disease or a history of cancer. In contrast, 145 (79.7%) of the included PE patients did not have a known cancer disease or a history of cancer. In the PE group with cancer, analysis of the ROC curve showed an AUC of 0.76 for cTnI predicting RVD with an optimal cut‐off value of 0.04 ng/mL; the risk of misclassification was 25.0%. In the PE group without cancer, AUC was 0.81 for cTnI predicting RVD with an optimal cut‐off value of 0.015 ng/mL; the risk of misclassification was 24.9%. Conclusions cTnI is effective for predicting RVD in PE patients with and without cancer. However, the effectiveness of cTnI to predict RVD was higher in PE patients without cancer than in those with cancer or a history of cancer.