The prognostic importance of thiol/disulfide homeostasis in patients with acute pulmonary thromboembolism.
OBJECTIVE
The aim of this study was to evaluate the role of thiol/disulfide homeostasis in acute pulmonary embolism (APE) and investigate its compliance to show hospital mortality of patients with APE.


METHODS
A total of 173 participants including 113 patients with APE, and 60 healthy individuals were included in the study. APE group was categorized into two subgroups according to Pulmonary Embolism Severity Index (PESI) clinic risk score (PESI low group [n=71, class 1-3] and PESI high group [n=42, class 4-5]).


RESULTS
Mean level of native thiol was lower and disulfide level and disulfide/total thiol ratio were higher in APE group than control group. In APE group, 14 patients died during hospitalization. Native thiol and disulfide level, presence of shock, heart rate, oxygen saturation, right ventricular dysfunction, N-terminal pro-brain natriuretic peptide, and creatinine levels were found to have prognostic significance in univariate analysis. On multilvariable logistic regression analysis, native thiol and disulfide level (odds ratio [OR], 1.16(0.87-1.36); P=.010 and OR, 1.49; P=.015, respectively), presence of shock (OR, 1.04; P=.012) and N-terminal pro-brain natriuretic peptide (OR, 1.67; P=.002) were strong predictors for APE-related hospital mortality after the adjustment of other potential confounders.


CONCLUSIONS
We have shown that thiol/disulfide homeostasis can be altered during APE and associated with worse hemodynamic parameters, and may be used as a prognostic marker for hospital mortality.
Adana Numune Training and research hospital, Cardiology, Adana, Turkey. Electronic address: topuzm46@gmail.com.
Mustafa
M
Topuz
Adana Numune Training and research hospital, Cardiology, Adana, Turkey.
Mehmet
M
Kaplan
Adana Numune Training and research hospital, Cardiology, Adana, Turkey.
Oguz
O
Akkus
Adana Numune Training and research hospital, Cardiology, Adana, Turkey.
Omer
O
Sen
Adana Numune Training and research hospital, Thoracic Medicine, Adana, Turkey.
Hatem Dilek
HD
Yunsel
Adana Numune Training and research hospital, Cardiology, Adana, Turkey.
Samir
S
Allahverdiyev
Yildirim Beyazit University, Biochemistry, Ankara, Turkey.
Ozcan
O
Erel
Adana Numune Training and research hospital, Cardiology, Adana, Turkey.
Mevlut
M
Koc
Adana Numune Training and research hospital, Cardiology, Adana, Turkey.
Mustafa
M
Gur
D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D004220:Disulfides / Q000097:blood*; D005260:Female; D006706:Homeostasis; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000097:blood* / Q000150:complications; D012720:Severity of Illness Index; D012769:Shock / Q000150:complications; D013438:Sulfhydryl Compounds / Q000097:blood*; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000503:physiopathology*
D015415:Biomarkers; D004220:Disulfides; D010446:Peptide Fragments; D013438:Sulfhydryl Compounds; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain