Open AccessCorrelations between electrocardiogram and biomarkers in acute pulmonary embolism: Analysis of ZATPOL ‐2 Registry
Author(s) -
Kukla Piotr,
Kosior Dariusz A.,
Tomaszewski Andrzej,
PtaszyńskaKopczyńska Katarzyna,
Widejko Katarzyna,
Długopolski Robert,
Skrzyński Andrzej,
Błaszczak Piotr,
Fijorek Kamil,
Kurzyna Marcin
Publication year - 2017
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/anec.12439
Subject(s) - medicine , pulmonary embolism , cardiology , st segment , electrocardiography , atrial fibrillation , t wave , chest pain , troponin , myocardial infarction
Background Electrocardiography ( ECG ) is still one of the first tests performed at admission, mostly in patients (pts) with chest pain or dyspnea. The aim of this study was to assess the correlation between electrocardiographic abnormalities and cardiac biomarkers as well as echocardiographic parameter in patients with acute pulmonary embolism. Methods We performed a retrospective analysis of 614 pts. (F/M 334/280; mean age of 67.9 ± 16.6 years) with confirmed acute pulmonary embolism ( APE ) who were enrolled to the ZATPOL ‐2 Registry between 2012 and 2014. Results Elevated cardiac biomarkers were observed in 358 pts (74.4%). In this group the presence of atrial fibrillation ( p = .008), right axis deviation ( p = .004), S 1 Q 3 T 3 sign ( p < .001), RBBB ( p = .006), ST segment depression in leads V 4 –V 6 ( p < .001), ST segment depression in lead I ( p = .01), negative T waves in leads V 1 –V 3 ( p < .001), negative T waves in leads V 4 –V 6 ( p = .005), negative T waves in leads II , III and a VF ( p = .005), ST segment elevation in lead a VR ( p = .002), ST segment elevation in lead III ( p = .0038) was significantly more frequent in comparison to subjects with normal serum level of cardiac biomarkers. In multivariate regression analysis, clinical predictors of “abnormal electrocardiogram” were as follows: increased heart rate ( OR 1.09, 95% CI 1.02–1.17, p = .012), elevated troponin concentration ( OR 3.33, 95% CI 1.94–5.72, p = .000), and right ventricular overload ( OR 2.30, 95% CI 1.17–4.53, p = .016). Conclusions Electrocardiographic signs of right ventricular strain are strongly related to elevated cardiac biomarkers and echocardiographic signs of right ventricular overload. ECG may be used in preliminary risk stratification of patient with intermediate‐ or high‐risk forms of APE .