Prediction of adverse clinical outcome in patients with acute pulmonary embolism : evaluation of high-sensitivity troponin I and quantitative CT parameters / Paul Apfaltrer, Thomas Walter, Joachim Gruettner, Frank Weilbacher, Mathias Meyer, Thomas Henzler, Michael Neumaier, Stefan O. Schoenberg, Christian Fink
PURPOSE: To evaluate the accuracy of high-sensitivity-cardiac-troponin-I (hs-cTnI) and quantitative CT-parameters, alone and in combination, for predicting right-ventricular-dysfunction (RVD) and adverse clinical outcome in patients with acute pulmonary embolism (PE). MATERIALS AND METHODS: 65 patients with PE and hs-cTnI measurements within 24 h of CT were retrospectively included. RVD was assessed on CT by calculating right ventricular/left ventricular (RV/LV) diameter ratios on transverse sections (RV/LVtrans), four-chamber-views (RV/LV4ch), and RV/LV volume ratio (RV/LVvol). Pulmonary CTA-obstruction-scores (OS) (Qanadli, Mastora) were calculated. Receiver operator characteristic (ROC) analysis was performed to compare Hs-cTnI, RV/LV ratios, and OS for predicting adverse clinical outcome (i.e. intensive care treatment, death). RESULTS: 12 patients with PE had adverse clinical outcome and showed significantly higher RV/LV ratios and OS compared to those without. ROC analysis revealed a cutoff value of 0.042 ng/mL for hs-cTnI resulting in a sensitivity and specificity of 84% and 92% for predicting adverse clinical outcome, respectively. Elevated hs-cTnI was significantly associated with adverse clinical outcome. In a ROC analysis the AUC for the prediction of adverse clinical outcome of RV/LV4Ch, RV/LVvol, and hs-cTnI were 0.77, 0.76, and 0.71. The combination of hs-cTnI and RV/LV ratios increased the AUC for the prediction of adverse clinical outcome. CONCLUSIONS: Hs-cTnI is associated with adverse clinical outcome in patients with acute PE. A combination of hs-cTnI with quantitative CT-parameters improves the prediction of adverse clinical outcome..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2013 |
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| Erschienen: |
2013 |
| Weitere Ausgaben: |
Erscheint auch als Druck-Ausgabe: Prediction of adverse clinical outcome in patients with acute pulmonary embolism |
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| Enthalten in: |
Zur Gesamtaufnahme - volume:82 |
| Enthalten in: |
European journal of radiology - 82(2013), 3, Seite 563-567 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Apfaltrer, Paul, 1983- [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Available online 10 December 2012k Gesehen am 28.06.2018 |
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| Umfang: |
5 |
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| doi: |
10.1016/j.ejrad.2012.11.009 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Prediction of adverse clinical outcome in patients with acute pulmonary embolism |b evaluation of high-sensitivity troponin I and quantitative CT parameters |c Paul Apfaltrer, Thomas Walter, Joachim Gruettner, Frank Weilbacher, Mathias Meyer, Thomas Henzler, Michael Neumaier, Stefan O. Schoenberg, Christian Fink |
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| 520 | |a PURPOSE: To evaluate the accuracy of high-sensitivity-cardiac-troponin-I (hs-cTnI) and quantitative CT-parameters, alone and in combination, for predicting right-ventricular-dysfunction (RVD) and adverse clinical outcome in patients with acute pulmonary embolism (PE). MATERIALS AND METHODS: 65 patients with PE and hs-cTnI measurements within 24 h of CT were retrospectively included. RVD was assessed on CT by calculating right ventricular/left ventricular (RV/LV) diameter ratios on transverse sections (RV/LVtrans), four-chamber-views (RV/LV4ch), and RV/LV volume ratio (RV/LVvol). Pulmonary CTA-obstruction-scores (OS) (Qanadli, Mastora) were calculated. Receiver operator characteristic (ROC) analysis was performed to compare Hs-cTnI, RV/LV ratios, and OS for predicting adverse clinical outcome (i.e. intensive care treatment, death). RESULTS: 12 patients with PE had adverse clinical outcome and showed significantly higher RV/LV ratios and OS compared to those without. ROC analysis revealed a cutoff value of 0.042 ng/mL for hs-cTnI resulting in a sensitivity and specificity of 84% and 92% for predicting adverse clinical outcome, respectively. Elevated hs-cTnI was significantly associated with adverse clinical outcome. In a ROC analysis the AUC for the prediction of adverse clinical outcome of RV/LV4Ch, RV/LVvol, and hs-cTnI were 0.77, 0.76, and 0.71. The combination of hs-cTnI and RV/LV ratios increased the AUC for the prediction of adverse clinical outcome. CONCLUSIONS: Hs-cTnI is associated with adverse clinical outcome in patients with acute PE. A combination of hs-cTnI with quantitative CT-parameters improves the prediction of adverse clinical outcome. | ||
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