Pulmonary vascular disease & thromboembolismSecondary analysis
High-Sensitivity vs Conventional Troponin Cutoffs for Risk Stratification in Patients With Acute Pulmonary Embolism
- Post hoc analysis of the PROTECT prospective cohort study
- multicentre
- 12 hospital EDs in Spain
Authors' conclusion
In this study of patients with hemodynamically stable PE, hs-cTnI identified modest elevations in cardiac troponin levels. However, the results did not provide additive clinical value compared with cTnI.
Study context
- Population
- Patients with hemodynamically stable acute pulmonary embolism (PE) presenting to EDs in Spainof 848 enrolled
- Participants
- 834 patients
- Comparison
- High-sensitivity cardiac troponin I (hs-cTnI) vs conventional cardiac troponin I (cTnI) cutoffs
- Primary endpoint
- Complicated course (hemodynamic collapse, recurrent PE or all-cause death)
- Follow-up
- 30 days after PE
Primary result
As reported in the abstract
Complicated course by troponin elevation (binary) · 30 days
Each group vs cTnIOdds ratio (95% CI)
cTnIelevated vs not elevated cTnI; complicated course
2.84(1.62–4.98)
hs-cTnIelevated vs not elevated hs-cTnI; complicated course
1.12(0.65–1.93)
- Complicated course, all patients
- 62 (7.4%; 95% CI, 5.7-9.4)
- Elevated hs-cTnI but normal cTnI (n = 125): complicated course
- 0 (95% CI, 0.0-2.9)
Further findings
European Society of Cardiology (ESC) 2019 risk designation
- ESC low risk with cTnI but not hsTnI (n = 78): complicated course
- 0 (95% CI, 0.0-4.6)
- hs-TnI classified fewer patients as low risk than cTnI
Original publication
High-Sensitivity vs Conventional Troponin Cutoffs for Risk Stratification in Patients With Acute Pulmonary Embolism. JAMA Cardiol. Published 1 January 2024. doi:10.1001/jamacardio.2023.4356
Summarised from the published abstract; every number is checked against it