Prediction of adverse clinical outcome in patients with acute pulmonary embolism

• Verfasst von: Apfaltrer, Paul [VerfasserIn]
• Verfasst von: Walter, Thomas [VerfasserIn]
• Verfasst von: Grüttner, Joachim [VerfasserIn]
• Verfasst von: Weilbacher, Frank [VerfasserIn]
• Verfasst von: Meyer, Mathias [VerfasserIn]
• Verfasst von: Henzler, Thomas [VerfasserIn]
• Verfasst von: Neumaier, Michael [VerfasserIn]
• Verfasst von: Schönberg, Stefan [VerfasserIn]
• Verfasst von: Fink, Christian [VerfasserIn]
• Titel: Prediction of adverse clinical outcome in patients with acute pulmonary embolism
• Titelzusatz: evaluation of high-sensitivity troponin I and quantitative CT parameters
• Verf.angabe: Paul Apfaltrer, Thomas Walter, Joachim Gruettner, Frank Weilbacher, Mathias Meyer, Thomas Henzler, Michael Neumaier, Stefan O. Schoenberg, Christian Fink
• Jahr: 2013
• Jahr des Originals: 2012
• Umfang: 5 S.
• Fussnoten: Available online 10 December 2012k ; Gesehen am 28.06.2018
• Titel Quelle: Enthalten in: European journal of radiology
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1990
• Jahr Quelle: 2013
• Band/Heft Quelle: 82(2013), 3, Seite 563-567
• ISSN Quelle: 1872-7727
• DOI: doi:10.1016/j.ejrad.2012.11.009
• Datenträger: Online-Ressource
• Sprache: eng
• Bibliogr. Hinweis: Erscheint auch als : Druck-Ausgabe: Apfaltrer, Paul, 1983 - : Prediction of adverse clinical outcome in patients with acute pulmonary embolism. - 2013
• Sach-SW: Acute Disease
• Sach-SW: Adult
• Sach-SW: Aged
• Sach-SW: Aged, 80 and over
• Sach-SW: Biomarkers
• Sach-SW: Female
• Sach-SW: Humans
• Sach-SW: Male
• Sach-SW: Middle Aged
• Sach-SW: Prognosis
• Sach-SW: Pulmonary Embolism
• Sach-SW: Reproducibility of Results
• Sach-SW: Retrospective Studies
• Sach-SW: Risk Assessment
• Sach-SW: Sensitivity and Specificity
• Sach-SW: Tomography, X-Ray Computed
• Sach-SW: Troponin I
• Sach-SW: Ventricular Dysfunction, Right
• Sach-SW: Young Adult
• K10plus-PPN: 1576984834

Abstract

PURPOSE: To evaluate the accuracy of high-sensitivity-cardiac-troponin-I (hs-cTnI) and quantitative CT-parameters, alone and in combination, for predicting right-ventricular-dysfunction (RVD) and adverse clinical outcome in patients with acute pulmonary embolism (PE). MATERIALS AND METHODS: 65 patients with PE and hs-cTnI measurements within 24 h of CT were retrospectively included. RVD was assessed on CT by calculating right ventricular/left ventricular (RV/LV) diameter ratios on transverse sections (RV/LVtrans), four-chamber-views (RV/LV4ch), and RV/LV volume ratio (RV/LVvol). Pulmonary CTA-obstruction-scores (OS) (Qanadli, Mastora) were calculated. Receiver operator characteristic (ROC) analysis was performed to compare Hs-cTnI, RV/LV ratios, and OS for predicting adverse clinical outcome (i.e. intensive care treatment, death). RESULTS: 12 patients with PE had adverse clinical outcome and showed significantly higher RV/LV ratios and OS compared to those without. ROC analysis revealed a cutoff value of 0.042 ng/mL for hs-cTnI resulting in a sensitivity and specificity of 84% and 92% for predicting adverse clinical outcome, respectively. Elevated hs-cTnI was significantly associated with adverse clinical outcome. In a ROC analysis the AUC for the prediction of adverse clinical outcome of RV/LV4Ch, RV/LVvol, and hs-cTnI were 0.77, 0.76, and 0.71. The combination of hs-cTnI and RV/LV ratios increased the AUC for the prediction of adverse clinical outcome. CONCLUSIONS: Hs-cTnI is associated with adverse clinical outcome in patients with acute PE. A combination of hs-cTnI with quantitative CT-parameters improves the prediction of adverse clinical outcome.