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Limited value of novel pulmonary embolism biomarkers in patients with coronary atherosclerosis
Author(s) -
Gutte Henrik,
Mortensen Jann,
Hag Anne M. F.,
Jensen Claus V.,
Kristoffersen Ulrik S.,
Brinth Louise,
Kjær Andreas
Publication year - 2011
Publication title -
clinical physiology and functional imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.608
H-Index - 67
eISSN - 1475-097X
pISSN - 1475-0961
DOI - 10.1111/j.1475-097x.2011.01043.x
Subject(s) - medicine , pulmonary embolism , cardiology , pulmonary angiography , coronary atherosclerosis , radiology , nuclear medicine , coronary artery disease
Summary Background: Recent research supports the efficacy of various plasma biomarkers in diagnosing pulmonary embolism (PE) including E‐selectin, MMP‐9, MPO, sVCAM‐1, sICAM‐1, adiponectin, hs‐CRP and tPAI‐1. Objective: We hypothesized that these biomarkers, which are affected in both venous and arterial thromboembolic diseases, have a limited potential of diagnosing PE in patients with concomitant coronary atherosclerosis, as assessed from a low‐dose CT scan of the thorax, compared to patients without atherosclerosis. Methods: Consecutive patients suspected of PE were referred. All patients had a ventilation/perfusion single photon emission tomography (V/Q‐SPECT), low‐dose pulmonary CT, pulmonary multidetector computer tomography angiography, blood samples and ECG‐gated cardiac CT performed the same day. Results: A total of 69 patients were included, of which 28 (41%) had PE. In patients without coronary calcium, MMP‐9 and tPAI‐1 were significantly elevated ( P <0·042 and P <0·049) in patients diagnosed with PE. From the receiver operating curves, we chose a cut‐off value for MMP‐9 at 164·4 ng l −1 , which yielded sensitivity, specificity, positive and negative predictive values of 63%, 78%, 71% and 70%, respectively. With a chosen cut‐off value for tPAI‐1 at 56·3 ng l −1 , the sensitivity, specificity, positive and negative predictive values were 88%, 89%, 88% and 89%, respectively. In patients with coronary calcium, none of the biomarkers could discriminate between PE and no PE. Conclusion: Plasma levels of tPAI‐1 and MMP‐9 are potentially useful in patients suspected of PE, however, not in the presence of the coronary atherosclerosis.