Effect of Beta-blockers on Tachycardia in Patients with Pulmonary Embolism

Aslam, Hafiz Muhammad; Naeem, Hafiz S; Prabhakar, S; Awwal, Talha; Khalid, Muhammad Rahman; Kaji, Anand

doi:10.7759/cureus.6512

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…It is difficult to distinguish PE patients from TPE patients based on their symptoms and signs alone. Furthermore, fever, chest pain, and dyspnoea often accelerate heart rate, which may increase the wells score [ 11 ]. Together with the elevated D-dimer levels, the clinical decision may be inclined to allow patients to undergo further radiological testing.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic performance of D-dimer in predicting pulmonary embolism in tuberculous pleural effusion patients

Qin²,

et al. 2021

BMC Pulm Med

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Background Tuberculous pleural effusion (TPE) patients usually have elevated D-dimer levels. The diagnostic performance of D-dimer in predicting pulmonary embolism (PE) in the TPE population is unclear. This study aimed to assess the diagnostic performance of D-dimer for PE in the TPE population and explore its potential mechanism. Methods We retrospectively analysed patients who were admitted to Xinhua Hospital and Weifang Respiratory Disease Hospital with confirmed TPE between March 2014 and January 2020. D-dimer levels were compared between patients with and without PE. To test the diagnostic performance of D-dimer in predicting PE, receiver operating characteristic curve analysis was performed. Positive predictive value (PPV) and negative predictive value (NPV) were also reported. To explore the potential mechanism of PE in TPE, inflammatory biomarkers were compared between PE and non-PE patients. Results This study included 248 patients (170 males and 78 females) aged 43 ± 20.6 years. Elevated D-dimer levels (≥ 0.5 mg/L) were detected in 186/248 (75%) patients. Of the 150 patients who underwent computed tomography pulmonary angiography, 29 were diagnosed with PE. Among the TPE population, the PE patients had significantly higher D-dimer levels than the non-PE patients (median, 1.06 mg/L vs. 0.84 mg/L, P < 0.05). The optimal cut-off value for D-dimer in predicting PE in TPE was 1.18 mg/L, with a sensitivity of 89.7% and a specificity of 77.8% (area under curve, 0.893; 95% confidence interval 0.839–0.947; P < 0.01). The PPV was 49.1%, while the NPV was 96.9% at a D-dimer cut-off of 1.18 mg/L for PE. PE patients had lower median WBC and interleukin (IL)-8 values (5.14 × 109/L vs. 6.1 × 109/L, P < 0.05; 30.2 pg/ml vs. 89.7 pg/ml, P < 0.05) but a higher median IL-2 receptor value (1964.8 pg/ml vs. 961.2 pg/ml, P < 0.01) than those in the non-PE patients. Conclusions D-dimer is an objective biomarker for predicting PE in patients with TPE. A D-dimer cut-off of 1.18 mg/L in the TPE population may reduce unnecessary radiological tests due to its excellent sensitivity, specificity, and NPV for PE. The imbalance of prothrombotic and antithrombotic cytokines may partly be attributed to the formation of pulmonary emboli in patients with TPE.

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Section: Discussionmentioning

confidence: 99%

Diagnostic performance of D-dimer in predicting pulmonary embolism in tuberculous pleural effusion patients

Qin²,

et al. 2021

BMC Pulm Med

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“…It is di cult to distinguish PE from the TPE patients by using symptoms. Furthermore, fever, chest pain and dyspnea often accelerate the heart rate which may increase the wells score [10] . When together with the elevated Ddimer level, the clinical decision may incline to let patients do the further radiological test.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Performance of D-dimer in Predicting Pulmonary Embolism in Tuberculosis Pleural Effusion Patients.

Qin²,

et al. 2020

Preprint

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Background: Tuberculosis pleural effusion patients always have elevated D-dimer levels. How D-dimer performance in predicting pulmonary embolism in TPE population is unclear. The aim of this study was to assess the diagnostic performance of D-dimer for pulmonary embolism in TPE population and explore the potential mechanism of PE in TPE patients.Methods: We retrospectively analyzed patients who were admitted to Xinhua hospital and Weifang Respiratory Disease Hospital with a final diagnosis of TPE between March 2014 and January 2020. Data including demographics, history, symptoms, D-dimer, C-reactive protein (CRP), white blood cell (WBC) and erythrocyte sedimentation rate (ESR) as well as the cytokines such as IL-6, IL-8, TNF-α, IL-2 receptor of the first blood test, imaging results including computed tomography pulmonary angiography (CTPA) and compression ultrasound (CUS) with Doppler were collected and analyzed. Results: 248 patients (male=170, female=78) at the age of 43±20.6 years were final included in this study. Elevated D-dimer (≥0.5mg/L) was detected in 186/248 (75%) patients. 150 patients received CTPA examination. PE was diagnosed in 29/150 (19.3%) patients. Among the TPE population, PE patients had significantly higher DD level than that of non-PE patients (2.26±0.96 mg/L VS 1.06±0.73 mg/L) (P＜0.05). An optimized cut off value for D-dimer in predicting PE in TPE was 1.18 mg/L, with a sensitivity of 89.7% and a specificity of 77.8 % ( area under curve was 0.893; 95% CI: 0.839-0.947; P＜0.01). PE patients had lower median WBC and IL-8 values (5.14Ⅹ109/L VS 6.1Ⅹ109/L, P＜0.05 ; 30.2 pg/ml VS 89.7 pg/ml, P＜0.05) but higher median IL-2 receptor value (1964.8 pg/ml VS 961.2 pg/ml, P＜0.01) than that of non-PE patients.Conclusions: D-dimer is still an objective biomarker to predict PE in TPE patients. In order to avoid unnecessary radiological test, the cut off value of D-dimer in TPE patients should be set at 1.18 mg/L. In addition, the imbalance of prothrombotic and antithrombotic cytokines may partly attribute to the formation of pulmonary embolus in TPE patients.

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The prognostic value of the MAGGIC risk score in patients with acute pulmonary embolism

Artac,

Ilis,

Karakayali

et al. 2024

The American Journal of the Medical Sciences

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Effect of Beta-blockers on Tachycardia in Patients with Pulmonary Embolism

Cited by 3 publications

References 20 publications

Diagnostic performance of D-dimer in predicting pulmonary embolism in tuberculous pleural effusion patients

Diagnostic performance of D-dimer in predicting pulmonary embolism in tuberculous pleural effusion patients

Diagnostic Performance of D-dimer in Predicting Pulmonary Embolism in Tuberculosis Pleural Effusion Patients.

The prognostic value of the MAGGIC risk score in patients with acute pulmonary embolism

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