Troponin-I in hemodynamically-stable pulmonary embolism: correlation with echocardiography and computed tomography angiography].

Troponin-I (TnI) is a marker of severe pulmonary thromboembolism (PTE) in unselected patients. There are few articles that assess its usefulness in hemodynamically-stable patients. To assess the correlation between TnI levels and both echocardiographic/radiologic signs of right ventricle (RV) dysfunction or pulmonary hypertension (PH), and the severity of the pulmonary vascular obstruction. We selected patients from a prospective cohort of 103 consecutive patients with PTE and systolic arterial pressure ≥ 90 mmHg. Computed tomography pulmonary angiography (CTPA) and echocardiography were performed in all patients. We performed a post hoc study, analyzing the 68 cases in which TnI was measured, at the discretion of the emergency room physician. Patients included had a median age of 74 years and 50% were male. The patients with elevated TnI had a differentiated clinical profile, suggestive of more severe PTE. There was a significant correlation between TnI levels and systolic pulmonary artery pressure (r=0.46, P<.001), the CTPA-measured pulmonary artery diameter (r=0.48, P<.001), the CTPA-measured RV diameter (r=0.47, P=.001) and the pulmonary vascular obstruction index (r=0.39, P=.001). The higher levels of TnI in patients with hemodynamically stable PTE predicts the existence of more severe PE in hemodynamically-stable patients. This biomarker could be used in the clinical practice to select those patients who might require more intensive monitoring or additional complementary studies. Copyright © 2010 Elsevier España, S.L. All rights reserved.

Citation

R Golpe, L A Pérez-de-Llano, O Castro-Añón, M Vázquez-Caruncho, C González-Juanatey, M C Fariñas. Troponin-I in hemodynamically-stable pulmonary embolism: correlation with echocardiography and computed tomography angiography]. Revista clínica española. 2011 Feb;211(2):69-75

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PMID: 21316656

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