Echocardiography and pulmonary embolism severity index have independent prognostic roles in pulmonary embolism
We analysed a cohort of patients with normotensive pulmonary embolism (PE) in order to assess whether combining echocardiography and biomarkers with the pulmonary embolism severity index (PESI) improves the risk stratification in comparison to the PESI alone. The PESI was calculated in normotensive...
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| Veröffentlicht in: | The European respiratory journal 2013-09, Vol.42 (3), p.681-688 |
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| creator | SANCHEZ, Olivier TRINQUART, Ludovic PERRIER, Arnaud BERTOLETTI, Laurent PARENT, Florence LORUT, Christine MEYER, Guy PLANQUETTE, Benjamin COUTURAUD, Francis VERSCHUREN, Franck CAILLE, Vincent MENEVEAU, Nicolas PACOURET, Gérard ROY, Pierre-Marie RIGHINI, Marc |
| description | We analysed a cohort of patients with normotensive pulmonary embolism (PE) in order to assess whether combining echocardiography and biomarkers with the pulmonary embolism severity index (PESI) improves the risk stratification in comparison to the PESI alone. The PESI was calculated in normotensive patients with PE who also underwent echocardiography and assays of cardiac troponin I and brain natriuretic peptide. 30-day adverse outcome was defined as death, recurrent PE or shock. 529 patients were included, 25 (4.7%, 95% CI 3.2-6.9%) had at least one outcome event. The proportion of patients with adverse events increased from 2.1% in PESI class I-II to 8.4% in PESI class III-IV, and to 14.3% in PESI class V (p |
| doi_str_mv | 10.1183/09031936.00097512 |
| format | Article |
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The PESI was calculated in normotensive patients with PE who also underwent echocardiography and assays of cardiac troponin I and brain natriuretic peptide. 30-day adverse outcome was defined as death, recurrent PE or shock. 529 patients were included, 25 (4.7%, 95% CI 3.2-6.9%) had at least one outcome event. The proportion of patients with adverse events increased from 2.1% in PESI class I-II to 8.4% in PESI class III-IV, and to 14.3% in PESI class V (p<0.001). In PESI class I-II, the rate of outcome events was significantly higher in patients with abnormal values of biomarkers or right ventricular dilatation. In multivariate analysis, the PESI (class III-IV versus I-II, OR 3.1, 95% CI 1.2-8.3; class V versus I-II, OR 5.5, 95% CI 1.5-25.5 and echocardiography (right ventricular/left ventricular ratio, OR (for an increase of 0.1) 1.3, 95% CI 1.1-1.5) were independent predictors of an adverse outcome. In patients with normotensive PE, biomarkers and echocardiography provided additional prognostic information to the PESI.</description><identifier>ISSN: 0903-1936</identifier><identifier>EISSN: 1399-3003</identifier><identifier>DOI: 10.1183/09031936.00097512</identifier><identifier>PMID: 23258789</identifier><language>eng</language><publisher>Leeds: Maney</publisher><subject>Aged ; Biological and medical sciences ; Biomarkers - blood ; Cardiovascular system ; Cohort Studies ; Dilatation, Pathologic - diagnostic imaging ; Echocardiography ; Female ; Heart Ventricles - diagnostic imaging ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Logistic Models ; Male ; Medical sciences ; Middle Aged ; Multivariate Analysis ; Natriuretic Peptide, Brain - blood ; Pneumology ; Prognosis ; Pulmonary Embolism - complications ; Pulmonary Embolism - diagnosis ; Pulmonary Embolism - mortality ; Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases ; Recurrence ; Risk Factors ; Severity of Illness Index ; Shock, Cardiogenic - etiology ; Troponin I - blood ; Ultrasonic investigative techniques</subject><ispartof>The European respiratory journal, 2013-09, Vol.42 (3), p.681-688</ispartof><rights>2014 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c374t-abcd83a389f350e11e116132d2a3e65526880ef2e069475f3a7ca59b9a16430f3</citedby><cites>FETCH-LOGICAL-c374t-abcd83a389f350e11e116132d2a3e65526880ef2e069475f3a7ca59b9a16430f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27656228$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23258789$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>SANCHEZ, Olivier</creatorcontrib><creatorcontrib>TRINQUART, Ludovic</creatorcontrib><creatorcontrib>PERRIER, Arnaud</creatorcontrib><creatorcontrib>BERTOLETTI, Laurent</creatorcontrib><creatorcontrib>PARENT, Florence</creatorcontrib><creatorcontrib>LORUT, Christine</creatorcontrib><creatorcontrib>MEYER, Guy</creatorcontrib><creatorcontrib>PLANQUETTE, Benjamin</creatorcontrib><creatorcontrib>COUTURAUD, Francis</creatorcontrib><creatorcontrib>VERSCHUREN, Franck</creatorcontrib><creatorcontrib>CAILLE, Vincent</creatorcontrib><creatorcontrib>MENEVEAU, Nicolas</creatorcontrib><creatorcontrib>PACOURET, Gérard</creatorcontrib><creatorcontrib>ROY, Pierre-Marie</creatorcontrib><creatorcontrib>RIGHINI, Marc</creatorcontrib><title>Echocardiography and pulmonary embolism severity index have independent prognostic roles in pulmonary embolism</title><title>The European respiratory journal</title><addtitle>Eur Respir J</addtitle><description>We analysed a cohort of patients with normotensive pulmonary embolism (PE) in order to assess whether combining echocardiography and biomarkers with the pulmonary embolism severity index (PESI) improves the risk stratification in comparison to the PESI alone. The PESI was calculated in normotensive patients with PE who also underwent echocardiography and assays of cardiac troponin I and brain natriuretic peptide. 30-day adverse outcome was defined as death, recurrent PE or shock. 529 patients were included, 25 (4.7%, 95% CI 3.2-6.9%) had at least one outcome event. The proportion of patients with adverse events increased from 2.1% in PESI class I-II to 8.4% in PESI class III-IV, and to 14.3% in PESI class V (p<0.001). In PESI class I-II, the rate of outcome events was significantly higher in patients with abnormal values of biomarkers or right ventricular dilatation. In multivariate analysis, the PESI (class III-IV versus I-II, OR 3.1, 95% CI 1.2-8.3; class V versus I-II, OR 5.5, 95% CI 1.5-25.5 and echocardiography (right ventricular/left ventricular ratio, OR (for an increase of 0.1) 1.3, 95% CI 1.1-1.5) were independent predictors of an adverse outcome. In patients with normotensive PE, biomarkers and echocardiography provided additional prognostic information to the PESI.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - blood</subject><subject>Cardiovascular system</subject><subject>Cohort Studies</subject><subject>Dilatation, Pathologic - diagnostic imaging</subject><subject>Echocardiography</subject><subject>Female</subject><subject>Heart Ventricles - diagnostic imaging</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Natriuretic Peptide, Brain - blood</subject><subject>Pneumology</subject><subject>Prognosis</subject><subject>Pulmonary Embolism - complications</subject><subject>Pulmonary Embolism - diagnosis</subject><subject>Pulmonary Embolism - mortality</subject><subject>Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases</subject><subject>Recurrence</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Shock, Cardiogenic - etiology</subject><subject>Troponin I - blood</subject><subject>Ultrasonic investigative techniques</subject><issn>0903-1936</issn><issn>1399-3003</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkE1PwzAMhiMEYmPwA7igXpC4dCRx0yZHNI0PaRIXOFdp6m5FbVOSdmL_npZtcEGybEt-_Mp-CblmdM6YhHuqKDAF8ZxSqhLB-AmZMlAqBErhlEzHeTgCE3Lh_QelLI6AnZMJBy5kItWUNEuzsUa7vLRrp9vNLtBNHrR9VdtGu12AdWar0teBxy26stsFZZPjV7DRW_xpWxxS0wWts-vG-q40gbMV-mH4j8wlOSt05fHqUGfk_XH5tngOV69PL4uHVWggibpQZyaXoEGqAgRFxoaIGfCca8BYCB5LSbHgSGMVJaIAnRgtVKb0-CEtYEbu9rrDWZ89-i6tS2-wqnSDtvcpi7iSUcJADCjbo8ZZ7x0WaevKejg6ZTQdbU6PNqdHm4edm4N8n9WY_24cfR2A2wOgvdFV4XRjSv_HJbGIOZfwDVf8hoM</recordid><startdate>20130901</startdate><enddate>20130901</enddate><creator>SANCHEZ, Olivier</creator><creator>TRINQUART, Ludovic</creator><creator>PERRIER, Arnaud</creator><creator>BERTOLETTI, Laurent</creator><creator>PARENT, Florence</creator><creator>LORUT, Christine</creator><creator>MEYER, Guy</creator><creator>PLANQUETTE, Benjamin</creator><creator>COUTURAUD, Francis</creator><creator>VERSCHUREN, Franck</creator><creator>CAILLE, Vincent</creator><creator>MENEVEAU, Nicolas</creator><creator>PACOURET, Gérard</creator><creator>ROY, Pierre-Marie</creator><creator>RIGHINI, Marc</creator><general>Maney</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130901</creationdate><title>Echocardiography and pulmonary embolism severity index have independent prognostic roles in pulmonary embolism</title><author>SANCHEZ, Olivier ; TRINQUART, Ludovic ; PERRIER, Arnaud ; BERTOLETTI, Laurent ; PARENT, Florence ; LORUT, Christine ; MEYER, Guy ; PLANQUETTE, Benjamin ; COUTURAUD, Francis ; VERSCHUREN, Franck ; CAILLE, Vincent ; MENEVEAU, Nicolas ; PACOURET, Gérard ; ROY, Pierre-Marie ; RIGHINI, Marc</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c374t-abcd83a389f350e11e116132d2a3e65526880ef2e069475f3a7ca59b9a16430f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - blood</topic><topic>Cardiovascular system</topic><topic>Cohort Studies</topic><topic>Dilatation, Pathologic - diagnostic imaging</topic><topic>Echocardiography</topic><topic>Female</topic><topic>Heart Ventricles - diagnostic imaging</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>Pneumology</topic><topic>Prognosis</topic><topic>Pulmonary Embolism - complications</topic><topic>Pulmonary Embolism - diagnosis</topic><topic>Pulmonary Embolism - mortality</topic><topic>Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases</topic><topic>Recurrence</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Shock, Cardiogenic - etiology</topic><topic>Troponin I - blood</topic><topic>Ultrasonic investigative techniques</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SANCHEZ, Olivier</creatorcontrib><creatorcontrib>TRINQUART, Ludovic</creatorcontrib><creatorcontrib>PERRIER, Arnaud</creatorcontrib><creatorcontrib>BERTOLETTI, Laurent</creatorcontrib><creatorcontrib>PARENT, Florence</creatorcontrib><creatorcontrib>LORUT, Christine</creatorcontrib><creatorcontrib>MEYER, Guy</creatorcontrib><creatorcontrib>PLANQUETTE, Benjamin</creatorcontrib><creatorcontrib>COUTURAUD, Francis</creatorcontrib><creatorcontrib>VERSCHUREN, Franck</creatorcontrib><creatorcontrib>CAILLE, Vincent</creatorcontrib><creatorcontrib>MENEVEAU, Nicolas</creatorcontrib><creatorcontrib>PACOURET, Gérard</creatorcontrib><creatorcontrib>ROY, Pierre-Marie</creatorcontrib><creatorcontrib>RIGHINI, Marc</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The European respiratory journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>SANCHEZ, Olivier</au><au>TRINQUART, Ludovic</au><au>PERRIER, Arnaud</au><au>BERTOLETTI, Laurent</au><au>PARENT, Florence</au><au>LORUT, Christine</au><au>MEYER, Guy</au><au>PLANQUETTE, Benjamin</au><au>COUTURAUD, Francis</au><au>VERSCHUREN, Franck</au><au>CAILLE, Vincent</au><au>MENEVEAU, Nicolas</au><au>PACOURET, Gérard</au><au>ROY, Pierre-Marie</au><au>RIGHINI, Marc</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Echocardiography and pulmonary embolism severity index have independent prognostic roles in pulmonary embolism</atitle><jtitle>The European respiratory journal</jtitle><addtitle>Eur Respir J</addtitle><date>2013-09-01</date><risdate>2013</risdate><volume>42</volume><issue>3</issue><spage>681</spage><epage>688</epage><pages>681-688</pages><issn>0903-1936</issn><eissn>1399-3003</eissn><abstract>We analysed a cohort of patients with normotensive pulmonary embolism (PE) in order to assess whether combining echocardiography and biomarkers with the pulmonary embolism severity index (PESI) improves the risk stratification in comparison to the PESI alone. The PESI was calculated in normotensive patients with PE who also underwent echocardiography and assays of cardiac troponin I and brain natriuretic peptide. 30-day adverse outcome was defined as death, recurrent PE or shock. 529 patients were included, 25 (4.7%, 95% CI 3.2-6.9%) had at least one outcome event. The proportion of patients with adverse events increased from 2.1% in PESI class I-II to 8.4% in PESI class III-IV, and to 14.3% in PESI class V (p<0.001). In PESI class I-II, the rate of outcome events was significantly higher in patients with abnormal values of biomarkers or right ventricular dilatation. In multivariate analysis, the PESI (class III-IV versus I-II, OR 3.1, 95% CI 1.2-8.3; class V versus I-II, OR 5.5, 95% CI 1.5-25.5 and echocardiography (right ventricular/left ventricular ratio, OR (for an increase of 0.1) 1.3, 95% CI 1.1-1.5) were independent predictors of an adverse outcome. In patients with normotensive PE, biomarkers and echocardiography provided additional prognostic information to the PESI.</abstract><cop>Leeds</cop><pub>Maney</pub><pmid>23258789</pmid><doi>10.1183/09031936.00097512</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Biological and medical sciences Biomarkers - blood Cardiovascular system Cohort Studies Dilatation, Pathologic - diagnostic imaging Echocardiography Female Heart Ventricles - diagnostic imaging Humans Investigative techniques, diagnostic techniques (general aspects) Logistic Models Male Medical sciences Middle Aged Multivariate Analysis Natriuretic Peptide, Brain - blood Pneumology Prognosis Pulmonary Embolism - complications Pulmonary Embolism - diagnosis Pulmonary Embolism - mortality Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases Recurrence Risk Factors Severity of Illness Index Shock, Cardiogenic - etiology Troponin I - blood Ultrasonic investigative techniques |
| title | Echocardiography and pulmonary embolism severity index have independent prognostic roles in pulmonary embolism |
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