title: Usefulness of combined assessment with computed tomographic signs of right ventricular dysfunction and cardiac troponin T for risk stratification of acute pulmonary embolism.
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.
authors.affiliation: Department of Radiology, Ajou University School of Medicine, Suwon, South Korea. kdklsm@ajou.ac.kr
authors.forename: Doo Kyoung
authors.initials: DK
authors.lastname: Kang
authors.forename: Joo Sung
authors.initials: JS
authors.lastname: Sun
authors.forename: Kyung Joo
authors.initials: KJ
authors.lastname: Park
authors.forename: Hong Seok
authors.initials: HS
authors.lastname: Lim
mesh_terms: D000368:Aged; D000792:Angiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate / Q000639:trends; D014057:Tomography, X-Ray Computed / Q000379:methods*; D020107:Troponin T / Q000097:blood*; D018497:Ventricular Dysfunction, Right / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging*
chemical_list: D020107:Troponin T