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Phlebologie 2013; 42(05): 261-269
DOI: 10.12687/phleb2138-5-2013
Originalarbeit
Schattauer GmbH

Troponin I for risk stratification in acute pulmonary embolism

Article in several languages: deutsch | English
K. Keller
1   2. Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz und Centrum für Thrombose und Hämostase (CTH), Universitätsmedizin Mainz, ehemals Klinik für Innere Medizin des Katholischen Klinikums Mainz (KKM), St. Vincenz und Elisabeth Hospital Mainz
,
J. Beule
2   Klinik für Innere Medizin des Katholischen Klinikums Mainz (KKM), St. Vincenz und Elisabeth Hospital Mainz
,
A. Schulz
3   2. Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz, Centrum für Thrombose und Hämostase (CTH), Universitätsmedizin Mainz
,
W. Dippold
4   Chefarzt der Klinik für Innere Medizin des Katholischen Klinikums Mainz (KKM), St. Vincenz und Elisabeth Hospital Mainz
› Author Affiliations
Further Information

Publication History

Eingegangen: 13 April 2013

Angenommen: 18 June 2013

Publication Date:
04 January 2018 (online)

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Summary

Introduction: A pulmonary embolism (PE) is a cardiovascular emercency with high mortality. Studies showed a relation between troponinlevel and right ventricular dysfunction (RVD) as well as increased mortality. The aim of our study was to test the relation between symptoms, examination results and especially the troponinlevels and RVD of patients with acute PE.

Methods: We analysed retrospectively the data of 179 patients, who were treated because a con-firmed PE between 2006 and 2011.

The patients were classified in PE-group with and without RVD. The data were ana-lysed especially focused on the Troponin I-levels and RVD.

Results: PE patients with RVD had significant higher troponinlevels than those without RVD (0.08 ng/ml vs. 0.01ng/ml, p<0.0001). The multivariable regression analysis showed a significant correlation between increased troponinlevel and RVD (OR 3.98; 95%CI: 2.17–7.31, p<0.0001). The calculated Troponin I cutoff value to detect a RVD was 0.01 ng/ml (ROC-curve: AUC=0.806).

Conclusions: Troponin I levels >0,01ng/ml point to a RVD in acute PE. Moreover increased D-Dimerlevels, PAP and heart rate and decreased systolic blood pressure as well as dyspnoea, syncope, collapse, hypotension tachycardia, RSB and S1Q3 type are connected with RVD.

English version available at: www.phlebologieonline.de

Keywords

Troponin - risk stratification - pulmonary embolism - RV dysfunction

* Die Studie wurde in der Klinik für Innere Medizin des Katholischen Klinikums Mainz – St. Vincenz und Elisabeth Hospitals Mainz (Chefarzt: Prof. Dr. med. W. Dippold) durchgeführt.