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首页> 外文期刊>European journal of cardio-thoracic surgery: Official journal of the European Association for Cardio-thoracic Surgery >Prognostic significance of cardiac troponin I on admission for surgical treatment of acute pulmonary embolism: a single-centre experience over more than 10 years.
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Prognostic significance of cardiac troponin I on admission for surgical treatment of acute pulmonary embolism: a single-centre experience over more than 10 years.

机译:心脏肌钙蛋白I入院对急性肺栓塞的手术治疗的预后意义:超过10年的单中心经验。

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摘要

Cardiac troponin I (cTnI) is a highly sensitive, specific marker for myocardial cell injury. We sought to determine whether cTnI on admission may help to identify patients with increased risk of open surgical embolectomy with acute pulmonary embolism (PE).Forty-six consecutive patients with confirmed acute PE were enrolled in this prospective study. PE was confirmed by pulmonary angiography, computed tomography (CT) scan or echocardiography. Severity of PE was assessed by clinical data, and cTnI was measured within 12?h after admission.cTnI was elevated in 28 patients with acute PE. Preoperative right ventricular dysfunction [odds ratio (OR): 15.2; 95% confidence interval (CI): 2.02-144.8; P?
机译:心肌肌钙蛋白I(cTnI)是心肌细胞损伤的高度敏感的特异性标志物。我们试图确定入院时cTnI是否可以帮助确定开放性栓塞手术并增加急性肺栓塞(PE)风险的患者。该前瞻性研究纳入了46例确诊为急性PE的连续患者。通过肺血管造影,计算机断层扫描(CT)扫描或超声心动图检查确认PE。通过临床资料评估PE的严重程度,并在入院后12小时内测量cTnI.28例急性PE患者中cTnI升高。术前右心功能不全[比值比(OR):15.2; 95%置信区间(CI):2.02-144.8; P 0.002],伴有心源性休克的长期低血压(OR:14.9; 95%CI:2.2-131.1; P 0.002)和术前需要复苏(OR:6.0; 95%CI:0.6-143.8; P cTnI血清浓度升高的患者更为普遍(α=?0.12)。 cTnI阳性患者也更需要肌力支持(OR:10.0; 95%CI:1.8-65.1; P 0.005)和机械通气(OR:13.5; 95%CI:2.2-95.6; P < 0.005)。此外,入院时cTnI水平升高与两个主要终点,院内死亡率(OR:9.0; 95%CI:1.0-215.2; P?=?0.03)和重大不良临床事件(OR:8.3; 95%)均显着相关。 CI:1.5-62.5;P≥0.006)。经过多变量风险调整后,cTnI阳性仍是院内死亡率(OR:13.6; 95%CI:3.22-145.8; P?=?0.014)和重大不良临床事件(OR:15.7; 95%CI)的独立预测因子:4.15-133.7; P?=?0.031)。入院时的cTnI可以改善因急性PE进行开放式手术栓塞术的患者的风险评估。

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