The utility of pulmonary computed tomography angiography (CTA) in the prediction of short- and long-term outcomes after pulmonary embolism (PE) is controversial. Between November 2011 and September 2014, 190 normotensive patients (age, 61 ± 16.90 years, 53.7 % female) were diagnosed with acute PE using a 128-slice dual-source pulmonary CTA scanner. All the related clinical and cardiovascular measurements were recorded. Primary endpoints were 30-day PE-related death, 30-day composite complications (death, hemodynamic instability, thrombolysis and thrombectomy, inotrope, and mechanical ventilation use), and long-term all-cause mortality during a median follow-up of 14.78 months. Overall 1-month mortality is 5.8 %, and death is PE-related in 4.7 % of total patients. Although non-significant, O2 saturation <90 % and the right ventricular short-axis to left ventricular short-axis diameters (RV/LV) ratio increase the risk of PE-related death by 3.5 and 2 times, respectively. The independent predictors of 30-day complications (15.8 %) are O2 saturation <90 % (OR: 3.924, 95 % CI 1.505-10.229), RV/LV ratio (OR: 3.018, 95 % CI 1.455-6.263), and heart rate ≥ 110 beats/min (OR: 2.607, 95 % CI 1.063-6.391). For long-term mortality (13.7 %), O2 saturation <90 % is an independent predictor (HR: 4.454, 95 % CI 2.016-8.862). The independent impact of the RV/LV ratio on the long-term mortality has a trend towards statistical significance (HR: 1.762, 95 % CI 0.968-4.218; p value = 0.064). The PE-related death is 4.7 % within 30 days after admisson and 13.7 % after a median follow-up of 14 months. Among the pulmonary CTA parameters, only the RV/LV ratio and among the clinical and paraclinical measures, O2 saturation <90 % remain independent predictors of short- and long-term mortality and complications after the diagnosis of PE.

Acute pulmonary embolism (PE) is a cardiovascular challenge with potentially fatal consequences.This study was designed to observe the association of novel cardiac biomarkers with outcome in this setting. In this prospective study, from 86 patients with a confirmed diagnosis of PE, 59 patients met the inclusion criteria (22 men, 37 women; mean age, 63.36±15.04 y). The plasma concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP), growth differentiation factor-15 (GDF-15), heart-type fatty acid-binding protein (H-FABP), tenascin-C, and D-dimer were measured at the time of confirmed diagnosis. The endpoints of the study were defined as the short-term adverse outcome and long-term all-cause mortality.Totally, 11.8% (7/59) of the patients had the short-term adverse outcome. The mean value of logNT-proBNP was 6.40±1.66 pg/ml. Among all the examined biomarkers, only the mean value of logNT-proBNP was significantly higher in the patients with the short-term adverse outcome (7.88±0.67 vs 6.22± 1.66 pg/ml; OR, 2.359; 95% CI, 1.037 to 5.367; p=0.041). After adjustment, a threefold increase in the short-term adverse outcome was identified (OR, 3.239; 95% CI, 0.877 to 11.967; p=0.078). Overall, 18.64% (11/59) of the patients had expired by the long-term follow-up. Moreover, adjustment revealed an evidence regarding association between increased logNT-proBNP levels and longterm mortality (HR, 2.163; 95%CI, 0.910 to 5.142; p=0.081).Our study could find evidences on association between increased level of NT-proBNP and short-term adverse outcome and/or long-term mortality in PE. This biomarker may be capable of improving prediction of outcome and clinical care in non-high-risk PE.

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Primary percutaneous coronary intervention (PPCI) is the gold standard of treatment in patients with acute ST-elevation myocardial infarction (STEMI). The no-reflow phenomenon (NRP) is a detrimental consequence of STEMI. Colchicine is an antiinflammatory drug that may help prevent the NRP and improve patient outcomes. In a randomized, double-blind, placebo-controlled clinical trial, 451 patients with acute STEMI who were candidates for PPCI and eligible for enrollment were randomized into the colchicine group (n = 229) and the control group (n = 222). About 321 patients were eligible to participate; 161 patients were assigned to the colchicine group, whereas 160 patients were assigned to the control group. Colchicine was administered 1 mg before PCI and 0.5 mg daily after the procedure until discharge. NRP, measured by angiographic findings including the thrombolysis in myocardial infarction flow grade and the thrombolysis in myocardial infarction myocardial perfusion grade, was reported as the primary outcome. Secondary end points included ST resolution 90 minutes after the procedure, P-selectin, high-sensitivity C-reactive protein, and troponin levels postprocedurally, predischarge ejection fraction, and major adverse cardiac events (MACE) at 1 month and 1 year after PPCI. NRP rates did not show a significant difference between the 2 groups (P = 0.98). Moreover, the levels of P-selectin, high-sensitivity C-reactive protein, and troponin were not significantly different. MACE and predischarge ejection fraction were also not significantly different between the groups. In patients with STEMI treated by PPCI, colchicine administered before PPCI was not associated with a signif-icant reduction in the NRP and MACE prevention (trial registration: IRCT20120111008698N23).