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PROGNOSTIC SIGNIFICANCE OF CARDIAC BIOMARKERS IN PATIENTS WITH ACUTE PULMONARY THROMBOEMBOLISM

Talat Kılıç, Süleyman Savaş Hacıevliyagil, Özkan Yetkin, Hakan Günen Inonu University Faculty of Medicine, Department of Pulmonary Medicine, Malatya, T URKIYE. PROGNOSTIC SIGNIFICANCE OF CARDIAC BIOMARKERS IN PATIENTS WITH ACUTE PULMONARY THROMBOEMBOLISM. Aim.

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PROGNOSTIC SIGNIFICANCE OF CARDIAC BIOMARKERS IN PATIENTS WITH ACUTE PULMONARY THROMBOEMBOLISM

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  1. Talat Kılıç, Süleyman Savaş Hacıevliyagil, Özkan Yetkin, Hakan GünenInonu University Faculty of Medicine, Department of Pulmonary Medicine, Malatya, TURKIYE PROGNOSTIC SIGNIFICANCE OF CARDIAC BIOMARKERS IN PATIENTS WITH ACUTE PULMONARY THROMBOEMBOLISM

  2. Aim • Hemodynamic status and right ventricular dysfunction (RVD) are very important in determining prognosis and choice of treatment in patients with pulmonary thromboembolism (PTE). • Due to the critical data provided, echocardiography (ECHO) has got significance particularly in the diagnosis of massive pulmonary embolism. • In our study, we have investigated the relationship between increased cardiac biomarkers and RVD, as an alternative to ECHO, and their prognostic value in patient with PTE.

  3. Materials and Methods • 50 consecutive patients with confirmed acute PTE were included in the study. • At the admission and after hospitalization, serum cTnI and BNP and MYG levels were measured. • ECHO was performed in all patients at the time of admission to detect possible RVD. • All patients were followed up in terms of the hospital mortality and major hospital complications.

  4. Results

  5. Cardiac biomarkers values of patients of PTE cTnI<0.1 ng/dl MYO: E:19-92 ng/dl,K:12-76 ng/dl BNP<65 pg/ml 56% of the patients had elevated cTnI, 76% of patients had elevated BNP, and 46% patients had elevated MYG.

  6. Complications during hospitalization period

  7. Complications during hospitalization period 46% of these patients (n=7) died during hospitalization period

  8. While significant relationship between the elevated cTnI and BNP levels, and RVD were detected, there was no significant relationship between the elevated MYG and RVD.

  9. Died Alive

  10. While the relationship between elevated cTnI and MYG concentrations and hospital mortality is significant, there was no relationship between the increased BNP and hospital mortality.

  11. The relationship between the increased cTnI, BNP and MYG levels, and major hospital complications were significant.

  12. The predictors of of hospital mortality and major hospital complications in multivariate analysis

  13. The predictors of of hospital mortality and major hospital complications in multivariate analysis Among the multiple parameters evaluated, only elevated cTnI level was found as a powerful independent predictor of hospital mortality and major hospital complications.

  14. Conclusions • As a result, we found that increased cardiac biomarkers indicated RVD, and they were important prognostic factors for major hospital complications including hospital mortality. • We think that all patients with elevated cardiac biomarker levels should be followed closely in terms of massive PTE, and should be evaluated for thrombolytic treatment.

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