Cardiac troponin T in the severity assessment of patients with pulmonary embolism: cohort study

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Abstract
We assessed 136 consecutive patients who were admitted to the emergency department of a tertiary care university hospital between December 1999 and November 2001 with pulmonary embolism, confirmed by computed tomography or scintigraphy. Two patients with terminal illness and seven patients admitted after cardiac arrest out of hospital were excluded. In 106 patients troponin concentrations were determined in the first 12 hours after admission (Elecsys 2010; Roche, Mannheim, Germany). The severity of the event was classified according to the grading system by Grosser (see table A on bmj.com).5 Right ventricular strain in the electrocardiogram was defined as right bundle branch block, T wave inversion in precordial leads, or S1Q3T3 pattern. We used Spearman's correlation and the Wilcoxon rank sum test and constructed a receiver operating characteristic curve based on sensitivities and specificities, using various troponin values as cut offs to determine mortality in hospital. We used routine data; studies using such data are not routinely reviewed by the local ethical review board.