Applying rigorous eligibility criteria to studies evaluating prognostic utility of serum biomarkers in pulmonary embolism: A systematic review and meta-analysis

Nithianandan, Harrish; Reilly, Aoife; Tritschler, Tobias; Wells, Phillip S.

doi:10.1016/j.thromres.2020.07.037

Cited by 15 publications

(15 citation statements)

References 34 publications

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“…13 Becattini et al 14 illustrated that D-dimer levels above the study cut-off were associated with both 30-day and 3-month mortalities in a meta-analysis. Nithianandan et al 15 found that cTnI >0.1 ng/mL predicted higher PErelated mortality in 30 days, as well as both NT-proBNP >500 pg/mL and NT-proBNP > 1000 pg/mL could predict long-term all-cause mortality and PE-related mortality. Therefore, hypoxemia, D-dimer, cTnI, BNP, and NT-proBNP might be predictive factors of mortality in SLE patients with PE but the small sample size led to insufficient statistical power in this study.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors of systemic lupus erythematosus patients with pulmonary embolism: An 11-year cohort study

Zhao

Huang

You

et al. 2022

Lupus

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Background Systemic lupus erythematosus (SLE) patients have a higher risk of pulmonary embolism (PE) which is life-threatening, but there has been no research focusing on the prognosis of SLE patients with PE. This study was conducted to explore the prognostic factors of mortality in SLE patients with PE. Methods In this observational cohort study, SLE inpatients with PE treated at Peking Union Medical College Hospital between January 2010 and December 2020 were included and age, gender, smoking history, the onset of SLE and PE, organ involvement, SLE disease activity index-2000 (SLEDAI-2K), severity of PE, and treatment regimen were collected. Kaplan–Meier survival curve and univariate and multivariate COX regression analysis were used to explore the prognostic factors of SLE patients with PE. Results A total of 86 SLE patients with PE were enrolled, with the age of 37.72±15.79 years old and the average lupus duration of 46.5 months. 17 patients (19.77%) died. 1- and 3-year survival rates were 83.40% and 79.40%. Thrombocytopenia (log-rank p = 0.004) and lymphocytopenia (log-rank p = 0.030) were predictors of mortality, and effective anticoagulation (log-rank p = 0.032), hydroxychloroquine (HCQ) (log-rank p = 0.021) were protective factors of mortality in SLE patients with PE. Effective anticoagulation was an independent protective factor of mortality in SLE patients with PE (HR = 0.14, p = 0.006). Conclusions Patients with thrombocytopenia and lymphocytopenia are more likely to develop a poor prognosis. Effective anticoagulation and HCQ could improve the prognosis.

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Section: Discussionmentioning

confidence: 99%

Prognostic factors of systemic lupus erythematosus patients with pulmonary embolism: An 11-year cohort study

Zhao

Huang

You

et al. 2022

Lupus

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“…Studies have shown [20,21] that the cTnI level of RVD patients is signi cantly higher than that of patients with normal right heart function, and the increase in cTnI level is a prognostic sign of increased short-term mortality in patients with acute pulmonary embolism. Harrish et al [22] proposed cTnI has certain value in predicting the 30-day mortality of PE patients. The combination of cTnI and quantitative CT parameters can improve the prediction of adverse clinical outcomes [23].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Therapeutic Effect of Pulmonary Embolism by CT Pulmonary Angiography Combined With Clinical Indexes

Cui

Yang

et al. 2021

Preprint

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Background To evaluate the value of CT pulmonary angiography (CTPA) in evaluating the therapeutic efficacy of pulmonary embolism (PE) through the study of CT pulmonary artery obstruction index (PAOI),right ventricular function parameters and some clinical indexes related to coagulation function and cardiac function injury.Materials and methods Select 30 patients with pulmonary embolism who underwent CTPA examination before and after treatment in our hospital, sort out their CTPA images before and after treatment, and obtain PAOI and right heart function parameters, including ascending aorta diameter (AAd), main pulmonary artery diameter (MPAd), ratio of main pulmonary artery diameter to ascending aorta diameter (MPAd/AAd), right pulmonary artery trunk diameter (RPAd), left pulmonary artery trunk diameter (LPAd), the ratio of the maximum short axis diameter of the right ventricle to the maximum short axis diameter of the left ventricle (RVd/LVd), and calculate the pulmonary artery obstruction index (PAOI).At the same time obtain the required clinical indicators, including serum D-dimer, N-terminal B-type natriuretic peptide precursor (NT-proBNP), cardiac troponin I (cTnI), myocardial enzyme profile (aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatine kinase (CK)).Results MPAd, RPAd, LPAd, RVd / LVd, PAOI, D-dimer, cTnI, CK, LDH, AST had significant changes after treatment (P < 0.05), while the other parameters and indexes had no significant differences before and after treatment (P > 0.05). PAOI is positively correlated with RVd/LVd, MPAd, D-dimer. The correlation coefficient ranges from 0.281 to 0.423, among which, the correlation with D-dimer is the closest, with a correlation coefficient of 0.423. There was no significant correlation between other parameters and PAOI (P < 0.05).Conclusion CTPA is of great significance in evaluating the severity of pulmonary embolism, right heart function and therapeutic efficacy.

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“…Troponin T (TnT) and troponin I (TnI) are released from cardiomyocytes in response to increased cell membrane permeability, as in the case of ischemia or stretching due to increased preload or afterload [19]. Elevated TnT and TnI levels have been associated with RV dysfunction in imaging studies as well as complicated outcomes in patients with PE [20][21][22][23][24]. However, the low positive predictive value of troponins make them an unsuitable solitary tool for risk stratification, but alternatively, the high negative predictive value for mortality (98% in [25]) of high-sensitivity TnT (hsTnT) with a cutoff of 14 ng/L is encouraging when used to distinguish patients at high risk of complications as part of a multimodal approach [1,25,26].…”

Section: Troponinsmentioning

confidence: 99%

Assessment of pulmonary embolism severity and the risk of early death

Pruszczyk¹,

Skowrońska²,

Ciurzyński³

et al. 2021

Polish Archives of Internal Medicine

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Applying rigorous eligibility criteria to studies evaluating prognostic utility of serum biomarkers in pulmonary embolism: A systematic review and meta-analysis

Cited by 15 publications

References 34 publications

Prognostic factors of systemic lupus erythematosus patients with pulmonary embolism: An 11-year cohort study

Prognostic factors of systemic lupus erythematosus patients with pulmonary embolism: An 11-year cohort study

Evaluation of the Therapeutic Effect of Pulmonary Embolism by CT Pulmonary Angiography Combined With Clinical Indexes

Assessment of pulmonary embolism severity and the risk of early death

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