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2 "Pulmonary thromboembolism"
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Original article
Troponin I and D-dimer levels as triaging biomarkers to distinguish acute pulmonary thromboembolism from myocardial infarction
Soo-Jin Kim, Moo Hyun Kim, Kwang Min Lee, Jin Woo Lee, Young Shin Cha, Da Eun Koh, Joo Yeong Hwang, Jong Sung Park
Kosin Med J. 2023;38(4):252-258.   Published online December 20, 2023
DOI: https://doi.org/10.7180/kmj.23.133
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  • 12 Download
  • 1 Citations
Abstract PDFPubReader   ePub   
Background
Acute pulmonary thromboembolism (APTE) is often confused with myocardial infarction. Previous studies have shown that patients with APTE exhibit lower initial and peak cardiac troponin I (CTI) levels, but higher D-dimer (DD) levels, than patients with myocardial infarction. The present study aimed to reaffirm the tree model algorithm using an entirely new set of data.
Methods
We reviewed retrospective clinical and laboratory data from patients who were diagnosed with APTE or non-ST-elevation myocardial infarction (NSTEMI) between 2015 and 2016. Subjects who were not classified with a diagnosis or did not have their CTI or DD levels assessed were excluded. We categorized patients according to the previous algorithm and compared the outcomes with the previous test dataset.
Results
The analysis involved data from 156 patients with APTE and 363 patients with NSTEMI. In the validation data set, the APTE group showed higher initial DD levels (9.80±10.84 μg/mL) and lower initial CTI levels (0.17±0.54 μg/mL) than the NSTEMI group. The accuracy rate for the test dataset and the validation set were similar. The test set accuracy rate was 91.0%, while the accuracy rate in the validation set improved to 88.6%.
Conclusions
Patients with APTE exhibited lower initial and peak CTI levels, but higher DD levels than NSTEMI patients. The accuracy rate estimates were similar between the test set obtained from the tree model algorithm and the validation set. The study findings demonstrate that the assessment of cardiac biomarkers can be useful for differentiating between APTE and NSTEMI.

Citations

Citations to this article as recorded by  
  • The old biomarkers you know are still useful: D-dimer and troponin I
    Sanghyun Lee
    Kosin Medical Journal.2023; 38(4): 229.     CrossRef
Case report
A case of rescuing a patient with acute cardiovascular instability from sudden and massive intraoperative pulmonary thromboembolism by extracorporeal membrane oxygenation
Won Jin Kim, Jin Gu Kang
Kosin Med J. 2018;33(3):477-482.   Published online December 31, 2018
DOI: https://doi.org/10.7180/kmj.2018.33.3.477
  • 801 View
  • 1 Download
Abstract PDFPubReader   

Intraoperative pulmonary thromboembolism is a high mortality situation. Early mortality in patients with pulmonary thromboembolism varies from 2% in normotensive patients to 30% in patients with cardiogenic shock. The use of extracorporeal cardiopulmonary resuscitation can improve survival and neurologic outcomes of cardiac arrest. We report a case of intraoperative massive pulmonary thromboembolism with circulatory collapse and cardiac arrest during anesthesia for pelvic bone fracture surgery, which were rescued by extracorporeal membrane oxygenation.


KMJ : Kosin Medical Journal