Author + information
- Katherine T. Lee Chuy,
- Emad Hakemi,
- Tareq Alyousef,
- Geetanjali Dang,
- Rami Doukky and
- John H. Stroger
Background: In patients with acute pulmonary embolism (APE), detectable highly sensitive cardiac troponin I (cTnl) has been associated with increased in-hospital mortality. We sought to investigate the impact of detectable cTnl on long-term survival.
Methods: In a retrospective cohort study, we analyzed consecutive patients (2008 – 2012) with confirmed APE and cTnl sample available from the index hospitalization. According to the Pulmonary Embolism Severity Index (PESI) score, patients were classified into low (≤ 85) and high (> 85) clinical risk groups. Detectable cTnl level was ≥ 0.012 ng/ml (VITROS Troponin I ES). Patients were followed using chart review and Social Security Death Index records. The primary outcome was all-cause mortality after hospital discharge.
Results: A cohort of 298 patients (mean age 56 y, 51% male), of whom 161 (54%) had a detectable cTnl, was followed for 36 ± 22 months. A total of 80 deaths were observed; 53 (33%) and 27 (20%) in the detectable and undetectable cTnl groups, respectively (p = 0.006). Post-discharge, 71 deaths were observed; 44 (27%) and 27 (20%) in the detectable and undetectable cTnl groups, respectively (p = 0.05). Detectable cTnl was predictive of long-term survival among low clinical risk patients, but not among high clinical risk patients, who had high mortality irrespective of cTnI level.
Conclusion: In patients with APE, detectable cTnI is predictive of long-term mortality, particularly among patients who were identified as low risk according to PESI score.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Updates on Pulmonary Embolism Management in 2017
Abstract Category: 35. Pulmonary Hypertension and Pulmonary Thrombo-embolic Disease
Presentation Number: 1141-005
- 2017 American College of Cardiology Foundation