• Pui-Lok Ng, Chi-Hang Kwok, Sik-Hon Tsui, and Hon-Kuan Tong.
• Department of Accident and Emergency, Queen Mary Hospital, 102 Pok Fu Lam Road, Pokfulam, Hong Kong Island, Hong Kong, China. lucypl@yahool.com
• Singap Med J. 2013 Feb 1; 54 (2): 86-9.

IntroductionAcute pulmonary embolism (PE) is an uncommon but potentially fatal disease. Acute right ventricular failure, which can be demonstrated by echocardiography, is known to be an adverse prognostic factor in patients with acute PE. However, this diagnostic test is not always available in emergency departments and it is also an operator-dependent investigation. This study aimed to investigate whether cardiac troponin I (cTnI) levels could predict clinical outcomes in Chinese patients with PE.MethodsThis was a retrospective cohort study performed in a tertiary regional hospital in Hong Kong. For this study, 100 patients who were diagnosed with acute PE between January 1, 2002 and December 31, 2009 were recruited. Information, including demographic data, presenting symptoms and vital signs at presentation, predisposing factors for PE, results of diagnostic procedures and clinical outcomes, was collected from the medical records of these patients.Results71% of recruited patients had elevated cTnI levels. High cTnI levels were associated with haemodynamic instability (odds ratio [OR] 5.30, 95% confidence interval [CI] 1.32-27.71; p = 0.019) and complicated clinical course (OR 6.34, 95% CI 1.76-22.9; p = 0.002).ConclusionElevated cTnI level was associated with a complicated clinical course in patients with acute PE. We suggest that measurements of cTnI levels be used for the early risk stratification of patients with PE in the emergency departments of hospitals.

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