Biomarkers for the prediction of early pulmonary embolism related mortality in spontaneous and provoked thrombotic disease(Article)
- aInstitute of Biochemistry, Military Medical Academy, Belgrade, Serbia
- bClinic of Cardiology and Emergency Internal Medicine, Military Medical Academy, Belgrade, Serbia
- cInstitute of Pulmonary Diseases Sremska Kamenica, School of Medicine, University of Novi Sad, Serbia
- dClinic of Cardiology, Clinical Center Nis, University of Nis, Serbia
- eUniversity Clinical Center Zvezdara, School of Medicine, University of Belgrade, Serbia
- fClinic of Cardiology, Clinical Center Kragujevac, School of Medicine, University of Kragujevac, Serbia
- gClinic of Cardiology, Clinical Center Banja Luka, School of Medicine, University of Banja Luka, Bosnia and Herzegovina
- hInstitute for Medical Statistics and Informatics, School of Medicine, University of Belgrade, Serbia
- iSchool of Medicine, University of Defense, Belgrade, Serbia
Abstract
Factors associated with provoked PE may influence a biomarker's predictive value for the primary outcome. The aim of this study was to investigate the value of BNP, cTnI, CRP and D-Dimer measurements taken soon after hospital admission for the prediction of 30-day PE-caused death in patients with spontaneous versus provoked PE.Data were extracted from a pool of 726 consecutive PE patients enrolled in the multicenter Serbian PE registry. Blood concentrations of BNP, cTnI, CRP and D-dimer were measured during the first 24 h of hospitalization. BNP blood level had strong predictive value for the primary outcome in spontaneous PE (c-statistics 0.943, 95% CI 0.882–1.000, p = .001) and a slightly lower predictive outcome in provoked PE (c-statistics 0.824, 95% CI 0.745–0.902, p < .001). NRI and IDI showed that none of the markers, when added to BNP, could improve Cox regression prediction models for 30-day PE-related mortality in either the spontaneous or provoked PE group. Blood levels of BNP measured during the first 24 h of hospital admission had an excellent predictive value for 30-day PE-related mortality in spontaneous PE and slightly lower predictive value in provoked PE, whereas CRP, cTnI and D-Dimer did not contribute significantly to the predictive value of BNP in either group. © 2019 Elsevier B.V.
Indexed keywords
| EMTREE drug terms: | biological markerbrain natriuretic peptideC reactive proteinD dimertroponinbiological marker |
|---|---|
| EMTREE medical terms: | adultagedArticlecontrolled studydiagnostic accuracydiagnostic test accuracy studyfemalehumanlung embolismmajor clinical studymalemiddle agedmortalitymortality riskpredictive valuepriority journalprotein blood levelprotein functionreceiver operating characteristicsensitivity and specificitythrombosisbloodcomplicationlung embolismprognosisretrospective studythrombosis |
| MeSH: | AgedBiomarkersFemaleHumansMaleMiddle AgedPrognosisPulmonary EmbolismRetrospective StudiesThrombosis |
Chemicals and CAS Registry Numbers:
brain natriuretic peptide, 114471-18-0; C reactive protein, 9007-41-4;
Biomarkers
- ISSN: 00098981
- CODEN: CCATA
- Source Type: Journal
- Original language: English
- DOI: 10.1016/j.cca.2019.02.008
- PubMed ID: 30768927
- Document Type: Article
- Publisher: Elsevier B.V.
Obradovic, S.; Clinic of Cardiology and Emergency Internal Medicine, Military Medical Academy, School of Medicine, University of Defense, Crnotravska 17, Belgrade, Serbia;
© Copyright 2019 Elsevier B.V., All rights reserved.
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