Poster No. 026 Prognostic value of cardiac biomarkers in acute pulmonary embolism: can it add something?

Abstract

Background Acute pulmonary thromboembolism (PE) is a life-threatening disease. Cardiac biomarkers like lactate, NT-proBNP and troponin I have been reported to predict prognosis of acute PE however, the prognostic importance of these factors on long-term mortality is not known. Objectives To assess the prognostic role of biomarkers lactate, NT-proBNP and troponin I in acute PE. Methods: We retrospectively assessed 131 consecutive patients diagnosed with acute PE. Prognostic impact of both lactate, NT-proBNP and troponin was assessed. Results Out of 131 patients with acute PE, the median age was 67.6 ± 15.3 years and 71.0% were female. Mean follow-up was 44.8 ± 37.3 months. Overall in-hospital mortality was 8.4%, 30-day mortality 13.0% and 1-year mortality 20.6%. Twenty-six patients (19.8%) had a recent hospitalization and 21 (16.0%) a medical history of active cancer. ROC curves shown that lactate has a good discriminatory power for in-hospital mortality, with an area under the curve (AUC) of 0.84 and p-value 0.001, unlike NT-proBNP (AUC 9.45, p-value 0.76) and troponin (AUC 0.64, p-value 0.12). Serum lactate equal or superior to 2.05 mmol/L were associated with higher in-hospital mortality (odds ratio [OR] 23.1, 95% confidence interval (CI) 2.8–187.7), when compared with lower levels. The impact of this parameter was independent of hypotension, tachycardia or active neoplasia (p-value 0.006, OR 21.3, 95% CI 2.4–187.3). Conclusions This study revealed that lactate has a better discriminatory power when compared to NT-proBNP and troponin in predicting prognosis in acute PE patients. Its routinely addition to current stratification tools could be of interest.