Risk stratification of elderly patients with acute pulmonary embolism
European Journal of Clinical Investigation Jul 03, 2019
Klingenberg R, et al. - Through a prospective multicenter SWITCO65+ study involving 214 patients aged ≥ 65 years with a new submassive pulmonary embolism (PE), researchers assessed how combining high-sensitivity cardiac Troponin T (hs-cTnT), NT-pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity C-reactive protein (hs-CRP) could enhance risk stratification of patients with PE beyond the PESI risk score. Unlike hs-CRP, participants in the highest quartile had a greater risk of death through the first 6 months for hs-cTnT and a trend for NT-proBNP as that with the lowest quartile. Further, the PESI risk score had the greatest prognostic accuracy for 6-month mortality—exceeding hs-cTnT, NT-proBNP and hs-CRP, respectively. However, no clinically relevant effect on risk stratification of the combination of all three biomarkers was evident when they were added to the PESI risk score. Hence, 6-month mortality could be projected by the PESI risk score alone in older patients.
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