Volume 66, Issue 6, Pages (December 2015)

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Volume 66, Issue 6, Pages 460-465 (December 2015) Predictive value of biomarkers for the prognosis of acute pulmonary embolism in Japanese patients: Results of the Tokyo CCU Network registry  Yasuhiro Tanabe, MD, Toru Obayashi, MD, PhD, Takeshi Yamamoto, MD, PhD, Morimasa Takayama, MD, PhD, Ken Nagao, MD, PhD  Journal of Cardiology  Volume 66, Issue 6, Pages 460-465 (December 2015) DOI: 10.1016/j.jjcc.2015.03.002 Copyright © 2015 Japanese College of Cardiology Terms and Conditions

Fig. 1 Study population. Between 2009 and 2011, 601 consecutive patients with acute pulmonary embolism were treated at institutions of the Tokyo CCU Network and registered by survey-forms. Of these, 160 cases were excluded because of insufficient information. Therefore, 441 cases were enrolled in this study. BNP, B-type natriuretic peptide. Journal of Cardiology 2015 66, 460-465DOI: (10.1016/j.jjcc.2015.03.002) Copyright © 2015 Japanese College of Cardiology Terms and Conditions

Fig. 2 Thirty-day mortality according to severity. The 30-day mortality rates according to severity were 1.8% (5/279) among non-massive type cases, 5.5% (6/109) among sub-massive type cases, 22.9% (8/35) among massive-type cases, and 44.4% (8/18) among collapse-type cases. Increases in the 30-day mortality were directly proportional to increases in pulmonary embolism severity (p<0.001). Journal of Cardiology 2015 66, 460-465DOI: (10.1016/j.jjcc.2015.03.002) Copyright © 2015 Japanese College of Cardiology Terms and Conditions

Fig. 3 BNP levels and 30-day mortality. Regarding all-cause, 30-day mortality, the median BNP level of the 30-day mortality group (n=10) was 545.0pg/mL (25th to 75th interquartile range: 169.8–761.2pg/mL), which was significantly higher than the median level of 181.6pg/mL (25th to 75th interquartile range: 45.2–464.0pg/mL) in the surviving group (n=200; p=0.016). BNP, B-type natriuretic peptide. Journal of Cardiology 2015 66, 460-465DOI: (10.1016/j.jjcc.2015.03.002) Copyright © 2015 Japanese College of Cardiology Terms and Conditions

Fig. 4 Receiver operating characteristic curve analysis for assessing the capacity of BNP to predict 30-day mortality provided an AUC of 0.73 (p=0.016; 95% confidence interval, 0.589–0.862). AUC, area under the curve. BNP, B-type natriuretic peptide. Journal of Cardiology 2015 66, 460-465DOI: (10.1016/j.jjcc.2015.03.002) Copyright © 2015 Japanese College of Cardiology Terms and Conditions

Fig. 5 Troponin status and 30-day mortality. The 30-day mortality rate for troponin-positive cases was 10.3%; this value was significantly higher than the rate of 2.1% for negative cases (p=0.017). Additionally, regarding 30-day mortality, the troponin positivity test had a sensitivity, specificity, positive predictive value, and negative predictive value of 66.7%, 73.3%, 10.3%, and 97.9%, respectively. Journal of Cardiology 2015 66, 460-465DOI: (10.1016/j.jjcc.2015.03.002) Copyright © 2015 Japanese College of Cardiology Terms and Conditions

Fig. 6 Blood glucose levels at admission and 30-day mortality. Among the 224 patients with blood glucose levels at admission between 70 and <150mg/dL, 8 (3.6%) died within 30 days, which was significantly lower than that of 11 (10.3%) among the 107 patients with glucose levels ≥150mg/dL (p=0.021). Journal of Cardiology 2015 66, 460-465DOI: (10.1016/j.jjcc.2015.03.002) Copyright © 2015 Japanese College of Cardiology Terms and Conditions

Fig. 7 Receiver operating characteristic curve analysis for assessing the capacity of blood glucose to predict 30-day mortality provided an AUC of 0.67 (p=0.013; 95% confidence interval, 0.560–0.781). AUC, area under the curve. Journal of Cardiology 2015 66, 460-465DOI: (10.1016/j.jjcc.2015.03.002) Copyright © 2015 Japanese College of Cardiology Terms and Conditions