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Usefulness of combined assessment with computed tomographic signs of right ventricular dysfunction and cardiac troponin T for risk stratification of acute pulmonary embolism.

Authors
Kang, DK; Sun, JS; Park, KJ; Lim, HS
Citation
The American journal of cardiology, 108(1):133-140, 2011
Journal Title
The American journal of cardiology
ISSN
0002-91491879-1913
Abstract
The aim of this study was to evaluate the incremental value of combined assessment with computed tomographic (CT) signs of right ventricular (RV) dysfunction and cardiac troponin T level for predicting early death or adverse outcomes due to acute pulmonary embolism (PE). One hundred seventy-three non-high-risk patients with acute PE, confirmed by CT pulmonary angiography, were retrospectively evaluated. The area under the curve and hazard ratio of CT signs and troponin T levels were compared for predicting early death or adverse outcomes. Patients were classified into intermediate- and low-risk groups on the basis of CT signs and troponin T levels, and mortality was compared. Seventeen patients (9.8%) died within 3 months. Early mortality of intermediate-risk patients (14% to 19%) was higher than that of low-risk patents (2% to 6%). A ratio of RV volume to left ventricular volume > 1.5 had the highest area under the curve (0.709) and hazard ratio (5.402) for predicting early death. The combination of CT signs and elevated troponin T level had an increased area under the curve and hazard ratio for predicting early death and adverse outcomes compared to those of CT signs or elevated troponin T level alone. In conclusion, the combined assessment of the ratio of RV volume to left ventricular volume and an elevated troponin T level provided incrementally more prognostic information in non-high-risk patients with acute PE compared to the single predictor of CT signs or troponin T level.
MeSH terms
AgedAngiography/*methodsFemaleFollow-Up StudiesHumansIncidenceMaleMiddle AgedPredictive Value of TestsPrognosisPulmonary Embolism/epidemiology/etiology/*radiographyRepublic of Korea/epidemiologyRetrospective Studies*Risk AssessmentSurvival Rate/trendsTomography, X-Ray Computed/*methodsTroponin T/*bloodVentricular Dysfunction, Right/blood/complications/*radiography
DOI
10.1016/j.amjcard.2011.03.009
PMID
21529730
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
AJOU Authors
강, 두경선, 주성박, 경주임, 홍석
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