Does
an Elevated Troponin Level Impact the Prognosis in the Setting of Acute
Pulmonary Embolism?
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Best
Evidence in Emergency Medicine Answer
Becattini C, Vedovati MC, Agnelli G; Prognostic value of
troponins
in acute PE: a meta-analysis, Circulation 2007; 116: 427-433.
(http://pmid.us/17606843).
Troponin
elevation in the setting of PE is associated with increased
short-term
mortality and other adverse outcomes.
Among
hemodynamically stable PE patients, the risk of short-term
(in-hospital)
death is 6%.
Based
upon the current meta-analysis, the hemodynamically stable
PE patient with an elevated Troponin has a 19% probability
of death during the hospitalization.
Troponin
adds to the prognostic value of right ventricular
echocardiography
and neither the specific assay nor the cutoff value used
impacts
the prognostic accuracy for death.
In
the future, Troponin may be used to risk stratify PE patients
suitable for outpatient management.
Authors
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