title: Predicting short term mortality after investigation for venous thromboembolism.
abstract: BACKGROUND
  Deaths following diagnosis of venous thromboembolism (VTE) often result from another concurrent illness. The specificity of mortality markers predicting death from pulmonary embolism is unknown. The aim of this analysis was to compare blood predictors of death in patients with confirmed VTE to patients with negative investigations for VTE.
  
  
  METHODS
  Consecutive patients investigated for VTE were prospectively consented from a single hospital over 9months. VTE was diagnosed and excluded with a standard diagnostic algorithm. Blood was drawn for biomarker analysis and analyzed in batches for NT-proBNP, high sensitivity troponin T, C-reactive protein (CRP), fatty acid binding protein (FABP) and ischemia modified albumin (IMA). Participants were followed for 3months. The cohort was analyzed in two groups: those diagnosed with VTE and those who had thrombosis excluded. Regression analysis for 3-month mortality was performed for each group.
  
  
  RESULTS
  16/153 patients diagnosed with VTE died within three months (10.5%) as did 23/606 patients who had negative investigations for VTE (3.8%). Predictors for death following VTE included cancer, NT-proBNP, troponin T, FABP, and Hb<95g/L. NT-proBNP>500pg/ml in acute cancer associated VTE predicted death with C-statistic of 0.89 (0.80-0.99). Cancer, NT-proBNP and troponin T also predicted death in patients with negative investigations for VTE.
  
  
  CONCLUSIONS
  Several blood markers are not specific for death from PE and may be surrogate markers of global declining health.
authors: The Manchester Academic Health Sciences Centre, Manchester, UK. kehogg@ohri.ca
authors: Kerstin
authors: K
authors: Hogg
authors: Edward
authors: E
authors: Hinchliffe
authors: Shonagh
authors: S
authors: Haslam
authors: Bilal
authors: B
authors: Sethi
authors: Marc
authors: M
authors: Carrier
authors: Fiona
authors: F
authors: Lecky
mesh_terms: D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D006113:United Kingdom / Q000453:epidemiology; D054556:Venous Thromboembolism / Q000097:blood / Q000175:diagnosis / Q000401:mortality*
chemical_list: D015415:Biomarkers