Raised troponin I in Chinese patients with acute pulmonary embolism suggests complicated clinical course and may predict intensive care unit admission

Abstract

INTRODUCTION Acute pulmonary embolism (PE) is an uncommon but potentially fatal disease. Acute right ventricular failure, which can be demonstrated by echocardiography, is known to be an adverse prognostic factor in patients with acute PE. However, this diagnostic test is not always available in emergency departments and it is also an operatordependent investigation. This study aimed to investigate whether cardiac troponin I (cTnI) levels could predict clinical outcomes in Chinese patients with PE. METHODS This was a retrospective cohort study performed in a tertiary regional hospital in Hong Kong. For this study, 100 patients who were diagnosed with acute PE between January 1, 2002 and December 31, 2009 were recruited. Information, including demographic data, presenting symptoms and vital signs at presentation, predisposing factors for PE, results of diagnostic procedures and clinical outcomes, was collected from the medical records of these patients. RESUlTS 71% of recruited patients had elevated cTnI levels. High cTnI levels were associated with haemodynamic instability (odds ratio [OR] 5.30, 95% confidence interval [CI] 1.32-27.71; p = 0.019) and complicated clinical course (OR 6.34, 95% CI 1.76-22.9; p = 0.002). CONClUSION Elevated cTnI level was associated with a complicated clinical course in patients with acute PE. We suggest that measurements of cTnI levels be used for the early risk stratification of patients with PE in the emergency departments of hospitals.