Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Aug 2:16:3301-3309.
doi: 10.2147/IJGM.S416541. eCollection 2023.

Impact of Promising Biomarkers on Severity and Outcome of Acute Pulmonary Embolism

Gulseren Sagcan  1 , Zeki Dogan  2 , Hafize Uzun  3 , Caglar Cuhadaroglu  1 , Gulfer Okumus  4 , Orhan Arseven  4
Affiliations

Impact of Promising Biomarkers on Severity and Outcome of Acute Pulmonary Embolism

Gulseren Sagcan et al. Int J Gen Med. .

Abstract

Background: Acute pulmonary embolism (APE) is a common clinical condition. Its severity ranges from asymptomatic radiological findings to fatal obstructive shock. The potential circulating biomarkers have been studied to predict APE outcomes. This study aimed to explore their predictive power on prognosis in APE.

Material and method: It was a prospective observational study between March 2008 and April 2010. All consecutive patients diagnosed with APE were categorized as massive/high-risk, submassive/moderate-risk, and non-massive/low-risk. Cardiac troponin T (cTnT), myoglobin, N-terminal pro-brain natriuretic peptide (NT-proBNP), heart-type fatty acid-binding protein (H-FABP), growth differentiation factor-15 (GDF-15), and D-dimer levels were measured.

Results: Of these patients, 14 (29.8%), 16 (34.0%), and 17 (36.2%) patients were categorized as low-risk, moderate-risk, and high risk-patients, respectively. There was no significant difference between the patient groups categorized based on the risk stratification in terms of demographic and clinical characteristics. The cTnT, myoglobin, HFABP, and D-dimer levels have also not differed significantly between the groups. There was a significant difference between the groups in respect of NT-proBNP and GDF-15 levels (p=0.009 and p=0.037, respectively). Nine (19.1%) patients had died by the 3rd-month follow-up. Adverse events were seen in 26 (55.3%) patients. GDF-15 had the highest area under the curve (AUC) value for predicting any adverse event (cut-off value=9.3 ng/mL, AUC=0.796, CI (confidence interval) 95%: 0.653-0.899). NT-ProBNP was determined as the best predictor for mortality (cut-off value=229.2 pg/mL, AUC=0.889, CI 95%: 0.756-0.964).

Conclusion: Higher levels of NT-proBNP and GDF-15 were found to be associated with more severe APE, worse outcomes, and mortality.

Keywords: adverse clinical outcome; biomarkers; growth differentiation factor-15; natriuretic peptides; pulmonary embolism.

PubMed Disclaimer

Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose for this work.

References

    1. Blondon M, Jimenez D, Robert‐Ebadi H, et al. Comparative clinical prognosis of massive and non‐massive pulmonary embolism: a registry‐based cohort study. J Thromb Haemost. 2021;19:408–416. doi:10.1111/jth.15146 - DOI - PubMed
    1. Gupta R, Ammari Z, Dasa O, et al. Long-term mortality after massive, submassive, and low-risk pulmonary embolism. Vasc Med. 2020;25:141–149. doi:10.1177/1358863X19886374 - DOI - PubMed
    1. Qian H-Y, Huang J, Yang Y-J, et al. Heart-type fatty acid binding protein in the assessment of acute pulmonary embolism. Am J Med Sci. 2016;352:557–562. doi:10.1016/j.amjms.2016.08.018 - DOI - PubMed
    1. Innocenti F, Lazzari C, Ricci F, Paolucci E, Agishev I, Pini R. D-dimer tests in the emergency department: current insights. Open Access Emerg Med. 2021;13:465–479. doi:10.2147/OAEM.S238696 - DOI - PMC - PubMed
    1. Andresen M, González A, Mercado M, et al. Natriuretic peptide type-B can be a marker of reperfusion in patients with pulmonary thromboembolism subjected to invasive treatment. Int J Cardiovasc Imaging. 2012;28:659–666. doi:10.1007/s10554-011-9857-7 - DOI - PubMed