title: Predictive value of troponins and simplified pulmonary embolism severity index in patients with normotensive pulmonary embolism.
abstract: BACKGROUND
  To investigate whether 2 cardiac troponins [conventional troponin-T(cTnT) and high sensitive troponin-T(hsTnT)] combined with simplified pulmonary embolism severity index (sPESI), or either test alone are useful for predicting 30-day mortality and 6 months adverse outcomes in patients with normotensive pulmonary embolism(PE).
  
  
  METHODS
  The prospective study included 121 consecutive patients with normotensive PE confirmed by computerized tomographic(CT) pulmonary angiography. The primary end point of the study was the 30-day all-cause mortality. The secondary end point included the 180-day all-cause mortality, the nonfatal symptomatic recurrent PE, or the nonfatal major bleeding.
  
  
  RESULTS
  Overall, 16 (13.2%) out of 121 patients died during the first month of follow up. The predefined hsTnT cutoff value of 0.014 ng/mL combined with a sPESI ≥1 'point(s) were the most significant predictor for 30-day mortality [OR: 27.6 (95% CI: 3.5-217) in the univariate analysis. Alone, sPESI ≥1 point(s) had the highest negative predictive value for both 30-day all-cause mortality and 6-months adverse outcomes,100% and 91% respectively.
  
  
  CONCLUSIONS
  The hsTnT assay combined with the sPESI may provide better predictive information than the cTnT assay for early death of PE patients. Low sPESI (0 points) may be used for identifying the outpatient treatment for PE patients and biomarker levels seem to be unnecessary for risk stratification in these patients.
authors.affiliation: Department of Pulmonary Medicine, Karadeniz Technical University, School of Medicine, Trabzon, Turkey. savasozsu@gmail.com.
authors.forename: Savas
authors.initials: S
authors.lastname: Ozsu
authors.forename: Yasin
authors.initials: Y
authors.lastname: Abul
authors.forename: Asim
authors.initials: A
authors.lastname: Orem
authors.forename: Funda
authors.initials: F
authors.lastname: Oztuna
authors.forename: Yilmaz
authors.initials: Y
authors.lastname: Bulbul
authors.forename: Huseyin
authors.initials: H
authors.lastname: Yaman
authors.forename: Tevfik
authors.initials: T
authors.lastname: Ozlu