scholarly journals Prognostic Role of Simplified Pulmonary Embolism Severity Index and the European Society of Cardiology Prognostic Model on Short- and Long-term Risk Stratification in Pulmonary Embolism.

1969 ◽  
Vol 30 (6) ◽  
Author(s):  
Talat Kilic ◽  
Hakan Günen ◽  
Gazi Gülbas ◽  
Suleyman Savas Hacievliyagil ◽  
Ali Özer
Keyword(s):  
Pulmonary Embolism ◽  
Risk Stratification ◽  
European Society ◽  
Prognostic Model ◽  
Severity Index ◽  
Prognostic Role ◽  
Short And Long Term ◽  
European Society Of Cardiology

Acute Pulmonary Embolism

2019 ◽  
Author(s):  
Brett J Carroll ◽  
Eric A Secemsky
Keyword(s):  
Pulmonary Embolism ◽  
Diagnostic Imaging ◽  
Risk Stratification ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Integrated Approach ◽  
Initial Management ◽  
Right Ventricular Strain ◽  
Thromboembolic Pulmonary Hypertension ◽  
Short And Long Term

Pulmonary embolism (PE) is a frequently encountered clinical condition with both short- and long-term adverse consequences. An integrated approach to diagnosis is important to maximize early diagnosis but also to minimize the unnecessary utilization of diagnostic imaging. Comprehensive risk stratification with clinical features and assessment of right ventricular strain by diagnostic imaging and cardiac biomarker results are essential to guide initial management decisions. There is a growing treatment arsenal for acute PE, including increased anticoagulation and advanced therapeutic options such as catheter-based therapy.  Despite such advances, mortality remains high, particularly among those who present critically ill with PE, and long-term physical and psychological effects can persist in many patients for years after the initial diagnosis. This review contains 7 figures, 6 tables, and 69 references. Key Words: anticoagulation, catheter-directed therapy, chronic thromboembolic pulmonary hypertension pulmonary embolism, computed tomography, echocardiography, fibrinolysis, risk stratification, venous thromboembolism

Sport and arrhythmias: summary of an international symposium

2007 ◽  
Vol 14 (5) ◽  
pp. 707-714 ◽  
Author(s):  
Franco Giada ◽  
Serge S. Barold ◽  
Alessandro Biffi ◽  
Bruno De Piccoli ◽  
Pietro Delise ◽  
...  
Keyword(s):  
Sudden Death ◽  
Risk Stratification ◽  
International Symposium ◽  
European Society ◽  
Cardiac Arrhythmias ◽  
Exercise Prescription ◽  
International Workshop ◽  
Sport And Exercise ◽  
European Society Of Cardiology

This article is the report of an International Symposium endorsed by the European Society of Cardiology, held within the Venice Arrhythmias 2007: 10th International Workshop on Cardiac Arrhythmias (Venice, October 2007). The topics of the Symposium are the following: how to stratify the risk of sudden death in the athletes; the role of different diagnostic examinations in the risk stratification of sudden death in the athletes; controversies on arrhythmias and sport; and exercise prescription in patients with arrhythmias. Eur J Cardiovasc Prev Rehabil14:707-714 © 2007 The European Society of Cardiology

scholarly journals Acute pulmonary embolism: mortality prediction by the 2014 European Society of Cardiology risk stratification model

2016 ◽  
Vol 48 (3) ◽  
pp. 780-786 ◽  
Author(s):  
Cecilia Becattini ◽  
Giancarlo Agnelli ◽  
Mareike Lankeit ◽  
Luca Masotti ◽  
Piotr Pruszczyk ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Risk Stratification ◽  
Negative Predictive Value ◽  
European Society ◽  
Predictive Value ◽  
Acute Pulmonary Embolism ◽  
Risk Stratification Model ◽  
Risk Patients ◽  
European Society Of Cardiology

The European Society of Cardiology (ESC) has proposed an updated risk stratification model for death in patients with acute pulmonary embolism based on clinical scores (Pulmonary Embolism Severity Index (PESI) or simplified PESI (sPESI)), right ventricle dysfunction (RVD) and elevated serum troponin (2014 ESC model).We assessed the ability of the 2014 ESC model to predict 30-day death after acute pulmonary embolism. Consecutive patients with symptomatic, confirmed pulmonary embolism included in prospective cohorts were merged in a collaborative database. Patients’ risk was classified as high (shock or hypotension), intermediate-high (RVD and elevated troponin), intermediate-low (RVD or increased troponin or none) and low (sPESI 0). Study outcomes were death and pulmonary embolism-related death at 30 days.Among 906 patients (mean±sd age 68±16, 489 females), death and pulmonary embolism-related death occurred in 7.2% and 4.1%, respectively. Death rate was 22% in “high-risk” (95% CI 14.0–29.8), 7.7% in “intermediate-high-risk” (95% CI 4.5–10.9) and 6.0% in “intermediate-low-risk” patients (95% CI 3.4–8.6). One of the 196 “low-risk” patients died (0.5%, 95% CI 0–1.0; negative predictive value 99.5%).By using the 2014 ESC model, RVD or troponin tests would be avoided in about 20% of patients (sPESI 0), preserving a high negative predictive value. Risk stratification in patients at intermediate risk requires further improvement.

scholarly journals Prognostic role of the simplified pulmonary embolism severity index and shock index in pulmonary embolism

2014 ◽  
Vol 124 (12) ◽  
pp. 678-687
Author(s):  
Talat Kilic ◽  
Hilal Ermis ◽  
Gazi Gülbas ◽  
Omar Kaya ◽  
Zeynep A. Aytemur ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Severity Index ◽  
Shock Index ◽  
Prognostic Role

scholarly journals High-sensitivity troponin I for risk stratification in normotensive pulmonary embolism

2020 ◽  
Vol 6 (4) ◽  
pp. 00625-2020
Author(s):  
Matthias Ebner ◽  
Niklas Guddat ◽  
Karsten Keller ◽  
Marie Christine Merten ◽  
Markus H. Lerchbaumer ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Risk Stratification ◽  
Troponin I ◽  
Adverse Outcome ◽  
High Sensitivity ◽  
Adverse Outcomes ◽  
Prognostic Role ◽  
High Sensitivity Troponin ◽  
All Cause Mortality

While numerous studies have confirmed the prognostic role of high-sensitivity troponin T (hsTnT) in pulmonary embolism (PE), high-sensitivity troponin I (hsTnI) is inappropriately studied. This study aimed to investigate the prognostic relevance of hsTnI in normotensive PE, establish the optimal cut-off value for risk stratification and to compare the prognostic performances of hsTnI and hsTnT.Based on data from 459 consecutive PE patients enrolled in a single-centre registry, receiver operating characteristic analysis was used to identify an optimal hsTnI cut-off value for prediction of in-hospital adverse outcomes (PE-related death, cardiopulmonary resuscitation or vasopressor treatment) and all-cause mortality.Patients who suffered an in-hospital adverse outcome (4.8%) had higher hsTnI concentrations compared with those with a favourable clinical course (57 (interquartile range (IQR) 22–197) versus 15 (IQR 10–86) pg·mL−1, p=0.03). A hsTnI cut-off value of 16 ng·mL−1 provided optimal prognostic performance and predicted in-hospital adverse outcomes (OR 6.5, 95% CI 1.9–22.4) and all-cause mortality (OR 3.7, 95% CI 1.0–13.3). Between female and male patients, no relevant differences in hsTnI concentrations (17 (IQR 10–97) versus 17 (IQR 10–92) pg·mL−1, p=0.79) or optimised cut-off values were observed. Risk stratification according to the 2019 European Society of Cardiology algorithm revealed no differences if calculated based on either hsTnI or hsTnT (p=0.68).Our findings confirm the prognostic role of hsTnI in normotensive PE. HsTnI concentrations >16 pg·mL−1 predicted in-hospital adverse outcome and all-cause mortality; sex-specific cut-off values do not seem necessary. Importantly, our results suggest that hsTnI and hsTnT can be used interchangeably for risk stratification.

Validation of the 2019 European Society of Cardiology risk stratification algorithm for pulmonary embolism in normotensive elderly patients

2021 ◽  
Author(s):  
Jeanne Moor ◽  
Christine Baumgartner ◽  
Marie Méan ◽  
Odile Stalder ◽  
Andreas Limacher ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Risk Stratification ◽  
European Society ◽  
Risk Groups ◽  
Adverse Outcomes ◽  
Low Risk ◽  
Receiver Operating Curve ◽  
European Society Of Cardiology ◽  
Related Mortality ◽  
Overall Mortality

Background: The 2019 European Society of Cardiology (ESC) guidelines recommend evaluation for right ventricular dysfunction in all normotensive patients with acute pulmonary embolism (PE). We compared the predictive performance of the 2019 and 2014 ESC risk stratification algorithms and the Pulmonary Embolism Severity Index (PESI). Methods: We performed a post-hoc analysis of normotensive patients aged ≥65 years with acute PE from a prospective cohort. The primary outcome was overall mortality; secondary outcomes were PE-related mortality and adverse outcomes (PE-related death, cardiopulmonary resuscitation, intubation, catecholamine use, recurrent venous thromboembolism) at 30 days. We assessed outcomes in intermediate-high, intermediate-low, and low risk groups according to the 2019 and 2014 ESC algorithms and the PESI. Discriminative power was compared using the area under the receiver operating curve (AUC). Results: Among 419 patients, 14 (3.3%) died (7 from PE) and 16 (3.8%) had adverse outcomes within 30 days. The 2019 ESC algorithm classified more patients as intermediate-high risk (45%) than the 2014 ESC algorithm (24%) or PESI (37%), and only 19% as low risk (32% with 2014 ESC or PESI). Discriminatory power for overall mortality was lower with the 2019 ESC algorithm (AUC 63.6%), compared to the 2014 ESC algorithm (AUC 71.5%) or PESI (AUC 75.2%), although the difference did not reach statistical significance (p=0.063). Discrimination for PE-related mortality and adverse outcomes was similar. Conclusions: While categorizing more patients in higher-risk groups, the 2019 ESC algorithm for PE did not improve prediction of short-term outcomes compared to the 2014 ESC algorithm or the PESI.

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