Diagnosis and prognosis of acute pulmonary embolism: focus on serum troponins

摘要

Pulmonary embolism is a common disease associated with high mortality. Death due tonpulmonary embolism occurs mainly before hospital admission or in the first hours of thenhospital stay. Prompt diagnosis and prognostic stratification and more intensive treatment innpatients with estimated high risk for adverse outcomes have the potential to reduce mortalityndue to pulmonary embolism. Significant advances have recently been made in the risknstratification for adverse outcomes in patients with pulmonary embolism and normal bloodnpressure. In these patients, right ventricle overload assessed by echocardiography and probablynby helical computerized tomography is a predictor of in-hospital mortality. Serum troponin isnrapidly available in the emergency room, and has a critical role in the management of patientsnwith acute coronary syndromes. The role of serum troponin in patients with pulmonarynembolism has been explored recently: it seems to be marginal in diagnosis while it cannsignificantly contribute to prognostic stratification. Elevated serum levels of troponins arenassociated with right ventricular overload and adverse in-hospital outcomes in patients withnpulmonary embolism and normal blood pressure.