Age-adjusted high-sensitivity troponin T cut-off value for risk stratification of pulmonary embolism

• Verfasst von: Käberich, Anja [VerfasserIn]
• Verfasst von: Giannitsis, Evangelos [VerfasserIn]
• Titel: Age-adjusted high-sensitivity troponin T cut-off value for risk stratification of pulmonary embolism
• Verf.angabe: Anja Kaeberich, Valerie Seeber, David Jiménez, Maciej Kostrubiec, Claudia Dellas, Gerd Hasenfuß, Evangelos Giannitsis, Piotr Pruszczyk, Stavros Konstantinides and Mareike Lankeit
• E-Jahr: 2015
• Jahr: Jan 22 2015
• Umfang: 9 S.
• Fussnoten: Gesehen am 17.06.2020
• Titel Quelle: Enthalten in: European respiratory journal
• Ort Quelle: Lausanne : ERS, 1988
• Jahr Quelle: 2015
• Band/Heft Quelle: 45(2015), 5, Seite 1323-1331
• ISSN Quelle: 1399-3003
• DOI: doi:10.1183/09031936.00174514
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1700332406

Abstract

High-sensitivity troponin T (hsTnT) helps in identifying pulmonary embolism patients at low risk of an adverse outcome. In 682 normotensive pulmonary embolism patients we investigate whether an optimised hsTnT cut-off value and adjustment for age improve the identification of patients at elevated risk. - Overall, 25 (3.7%) patients had an adverse 30-day outcome. The established hsTnT cut-off value of 14 pg·mL−1 retained its high prognostic value (OR (95% CI) 16.64 (2.24-123.74); p=0.006) compared with the cut-off value of 33 pg·mL−1 calculated by receiver operating characteristic analysis (7.14 (2.64-19.26); p<0.001). In elderly (aged ≥75 years) patients, an age-optimised hsTnT cut-off value of 45 pg·mL−1 but not the established cut-off value of 14 pg·mL−1 predicted an adverse outcome. An age-adjusted hsTnT cut-off value (≥14 pg·mL−1 for patients aged <75 years and ≥45 pg·mL−1 for patients aged ≥75 years) provided additive and independent prognostic information on top of the simplified pulmonary embolism severity index (sPESI) and echocardiography (OR 4.56 (1.30-16.01); p=0.018, C-index=0.77). A three-step approach based on the sPESI, hsTnT and echocardiography identified 16.6% of all patients as being at higher risk (12.4% adverse outcome). - Risk assessment of normotensive pulmonary embolism patients was improved by the introduction of an age-adjusted hsTnT cut-off value. A three-step approach helped identify patients at higher risk of an adverse outcome who might benefit from advanced therapy. - Tweetable abstract @ERSpublications - click to tweetAge-adjusted hsTnT cut-off values for risk stratification of pulmonary embolism provide additive prognostic information. http://ow.ly/FmcZl