Biomarkers for the prediction of early pulmonary embolism related mortality in spontaneous and provoked thrombotic disease

Publication date: Available online 12 February 2019Source: Clinica Chimica ActaAuthor(s): Ljiljana Jovanovic, Vesna Subota, Milena Stavric, Bojana Subotic, Boris Dzudovic, Natasa Novicic, Jovan Matijasevic, Milica Miric, Sonja Salinger, Natasa Markovic-Nikolic, Maja Nikolic, Vladimir Miloradovic, Ljiljana Kos, Tamara Kovacevic-Preradovic, Jelena Marinkovic, Nikola Kocev, Slobodan ObradovicAbstractFactors 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 predict...
Source: Clinica Chimica Acta - Category: Laboratory Medicine Source Type: research