Biomarkers for the prediction of early pulmonary embolism related mortality in spontaneous and provoked thrombotic disease.
Clin Chim Acta. 2019 Feb 12;:
Authors: Jovanovic L, Subota V, Stavric M, Subotic B, Dzudovic B, Novicic N, Matijasevic J, Miric M, Salinger S, Markovic-Nikolic N, Nikolic M, Miloradovic V, Kos L, Kovacevic-Preradovic T, Marinkovic J, Kocev N, Obradovic S
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.
PMID: 30768927 [PubMed - as supplied by publisher]