Clinical usefulness and prognostic value of elevated cardiac troponin I levels in acute pulmonary embolism

American Heart Journal
Nirav J MehtaIjaz A Khan

Abstract

Right ventricular myocardial ischemia and injury contribute to right ventricular dysfunction and failure during acute pulmonary embolism. The objective of this study was to evaluate the clinical usefulness of cardiac troponin I (cTnI) in the assessment of right ventricular involvement and short-term prognosis in acute pulmonary embolism Thirty-eight patients with acute pulmonary embolism were included in the study. Clinical characteristics, right ventricular involvement, and clinical outcome were compared in patients with elevated levels of serum cTnI versus patients with normal levels of serum cTnI. Among the study population (n = 38 patients), 18 patients (47%) had elevated cTnI levels (mean +/- SD 1.6 +/- 0.7 ng/mL, range 0.7-3.7 ng/mL, median, 1.4 ng/mL), and comprised the cTnI-positive group. In the other 20 patients, the serum cTnI levels were normal (< or =0.4 ng/mL), and they comprised the cTnI-negative group. In the cTnI-positive group (n = 18 patients), 12 patients (67%) had right ventricular dilatation/hypokinesia, compared with 3 patients (15%) in the cTnI-negative group (n = 20 patients, P =.004). Right ventricular systolic pressure was significantly higher in the cTnI-positive group (51 +/- 8 mm Hg vs 40 +/- 9 mm ...Continue Reading

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