Is there a demonstrated relationship between elevated troponin levels and risk of death from pulmonary embolism (PE)?

Updated: Jun 06, 2019
  • Author: Daniel R Ouellette, MD, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

A meta-analysis by Jimenez et al suggested that in acute symptomatic pulmonary embolism, elevated troponin levels do not distinguish between patients who are at high risk for death and those who are at low risk. Pooled results from studies including 1366 normotensive patients with acute symptomatic pulmonary embolism showed that elevated troponin levels were associated with a 4.26-fold increased odds of overall mortality (95% confidence interval [CI], 2.13-8.50; heterogeneity chi2 = 12.64; degrees of freedom = 8; P = .125). Summary receiver operating characteristic curve analysis showed a relationship between the sensitivity and specificity of troponin levels to predict overall mortality (Spearman rank correlation coefficient = 0.68; P = .046). Pooled likelihood ratios (LRs) were not extreme (negative LR, 0.59 [95% CI, 0.39-0.88]; positive LR, 2.26 [95% CI,1.66-3.07]). [55]


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