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One hundred and thirty six consecutive patients with PE (diagnosed by CT or scintigraphy) presenting to an emergency department in Austria were assessed. Troponin T concentrations were measured in 106 patients and 93 underwent echocardiography. PE was classified according to severity. Five of the 106 patients died in hospital. Increasing troponin T concentrations were found with increasing severity of PE (minor, submassive and massive). In addition, higher median concentrations of troponin T were observed in patients with signs of right ventricular strain on ECG or echocardiography. Troponin T concentrations were higher in patients who died than in survivors, allowing the investigators to give a cut off value of 0.09 ng/l as a predictor of in-hospital death with reasonable sensitivity and specificity.
Despite the small numbers and incomplete data, this study raises the question of whether troponin T levels in PE can be used to aid clinical decision making; in particular, whether or not thrombolytic therapy can be administered on this basis may deserve further study.
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