Prognostic Value Of Troponins In Pulmonary Embolism An Update Meta-analysis

Objectives Literatures published from2003to2012that reported on the prognostic value of troponins in pulmonary embolism were quantified by Meta-analysis to evaluate the correlations between elevated troponin levels and all-cause mortality、acute pulmonary embolism(APE)-related mortality and serious adverse events in patients with APE to make clear the role of troponin in the risk stratificationMethods PubMed,Web of Science,OVID databases were searched between January1,2003and May1,2012and cited references in those publications would be included if a2*2table could be constructed based on troponin results and at least one of the outcomes. Quality assessment and data extraction were performed in the articles selected according to inclusion and exclusion criteria.Meta-analyses were carried out using statistical software Stata (Version11.0,Stata Corporation) and Meta-Disc adopting fixed or random model based on the heterogeneity test.Results33studies that consisted of7538patients with acute symptomatic PE were deemed eligible.Pooled results showed that APE patients with elevated troponin levels were associated with a increased odds of overall mortality,death resulting from pulmonary embolism and adverse outcome events (OR3.86,95%CI2.79to5.33; OR4.46,95%CI3.02to6.57; OR4.46,95%CI3.02to6.57) during short time follow-up.Results were consistent for troponin I or T and prospective or retrospective studies.Summary receiver operating characteristic curve analysis showed a relationship between the sensitivity and specificity of troponin levels to predict overall mortality. Conclusions This study suggests significant correlations between elevated troponin levels and all-cause mortality,APE-related mortality and serious adverse events in patients with APE. Troponin can be measured for the risk stratification of APE to guide a better treatment.