Release Kinetics of Cardiac Troponin T in Survivors of Confirmed Severe Pulmonary Embolism

Abstract

Cardiac troponins may be increased in patients with confirmed pulmonary embolism (PE), even in the absence of significant coronary artery disease (CAD), and indicate increased risk for subsequent death (1). Cardiac troponin T (cTnT) correlates with the presence and degree of right-ventricular dysfunction (1)(2). In our recent study (1), 18 of 56 patients (32%) with PE had significant increases in cTnT. Eight of the nine patients with fatal outcome had increased cTnT. In the present study, we investigated all consecutive survivors of angiographically confirmed acute PE who developed cTnT ≥0.1 μg/L to evaluate cTnT time release in PE and to provide a rationale for an optimal blood-sampling protocol to improve risk stratification. The study was approved by the local ethics committee of the University of Luebeck. All patients gave informed consent. We enrolled nine consecutive patients with confirmed PE developing cTnT concentrations ≥0.1 μg/L, who survived the acute event and sampling period until normalization of cTnT concentrations. PE was suspected in the presence of an acute onset of symptoms such as dyspnea, pleuritic chest pain, syncope, hypotension, or shock and was confirmed by pulmonary angiography. The diagnostic work-up included transthoracic echocardiography, electrocardiography, blood-gas analysis, ventilation-perfusion scan, and coronary angiography. PE was graded …