Troponin I and D-dimer levels as triaging biomarkers to distinguish acute pulmonary thromboembolism from myocardial infarction
Background Acute pulmonary thromboembolism (APTE) is often confused with myocardial infarction. Previous studies have shown that patients with APTE exhibit lower initial and peak cardiac troponin I (CTI) levels, but higher D-dimer (DD) levels, than patients with myocardial infarction. The present st...
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| Format: | Article |
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Kosin University College of Medicine
2023-12-01
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| Series: | Kosin Medical Journal |
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| Online Access: | http://www.kosinmedj.org/upload/pdf/kmj-23-133.pdf |
| _version_ | 1797373009646845952 |
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| author | Soo-Jin Kim Moo Hyun Kim Kwang Min Lee Jin Woo Lee Young Shin Cha Da Eun Koh Joo Yeong Hwang Jong Sung Park |
| author_facet | Soo-Jin Kim Moo Hyun Kim Kwang Min Lee Jin Woo Lee Young Shin Cha Da Eun Koh Joo Yeong Hwang Jong Sung Park |
| author_sort | Soo-Jin Kim |
| collection | DOAJ |
| description | Background Acute pulmonary thromboembolism (APTE) is often confused with myocardial infarction. Previous studies have shown that patients with APTE exhibit lower initial and peak cardiac troponin I (CTI) levels, but higher D-dimer (DD) levels, than patients with myocardial infarction. The present study aimed to reaffirm the tree model algorithm using an entirely new set of data. Methods We reviewed retrospective clinical and laboratory data from patients who were diagnosed with APTE or non-ST-elevation myocardial infarction (NSTEMI) between 2015 and 2016. Subjects who were not classified with a diagnosis or did not have their CTI or DD levels assessed were excluded. We categorized patients according to the previous algorithm and compared the outcomes with the previous test dataset. Results The analysis involved data from 156 patients with APTE and 363 patients with NSTEMI. In the validation data set, the APTE group showed higher initial DD levels (9.80±10.84 μg/mL) and lower initial CTI levels (0.17±0.54 μg/mL) than the NSTEMI group. The accuracy rate for the test dataset and the validation set were similar. The test set accuracy rate was 91.0%, while the accuracy rate in the validation set improved to 88.6%. Conclusions Patients with APTE exhibited lower initial and peak CTI levels, but higher DD levels than NSTEMI patients. The accuracy rate estimates were similar between the test set obtained from the tree model algorithm and the validation set. The study findings demonstrate that the assessment of cardiac biomarkers can be useful for differentiating between APTE and NSTEMI. |
| first_indexed | 2024-03-08T18:44:09Z |
| format | Article |
| id | doaj.art-8f557a341f6d4ae0bfa91f86eee582e8 |
| institution | Directory Open Access Journal |
| issn | 2005-9531 2586-7024 |
| language | English |
| last_indexed | 2024-03-08T18:44:09Z |
| publishDate | 2023-12-01 |
| publisher | Kosin University College of Medicine |
| record_format | Article |
| series | Kosin Medical Journal |
| spelling | doaj.art-8f557a341f6d4ae0bfa91f86eee582e82023-12-29T01:19:07ZengKosin University College of MedicineKosin Medical Journal2005-95312586-70242023-12-0138425225810.7180/kmj.23.1331257Troponin I and D-dimer levels as triaging biomarkers to distinguish acute pulmonary thromboembolism from myocardial infarctionSoo-Jin Kim0Moo Hyun Kim1Kwang Min Lee2Jin Woo Lee3Young Shin Cha4Da Eun Koh5Joo Yeong Hwang6Jong Sung Park7 Division of Cardiology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea Department of Cardiology, Dong-A University Hospital, Busan, Korea Department of Cardiology, Dong-A University Hospital, Busan, Korea Department of Cardiology, Dong-A University Hospital, Busan, Korea Department of Cardiology, Dong-A University Hospital, Busan, Korea Department of Cardiology, Dong-A University Hospital, Busan, Korea Department of Cardiology, Dong-A University Hospital, Busan, Korea Department of Cardiology, Dong-A University Hospital, Busan, KoreaBackground Acute pulmonary thromboembolism (APTE) is often confused with myocardial infarction. Previous studies have shown that patients with APTE exhibit lower initial and peak cardiac troponin I (CTI) levels, but higher D-dimer (DD) levels, than patients with myocardial infarction. The present study aimed to reaffirm the tree model algorithm using an entirely new set of data. Methods We reviewed retrospective clinical and laboratory data from patients who were diagnosed with APTE or non-ST-elevation myocardial infarction (NSTEMI) between 2015 and 2016. Subjects who were not classified with a diagnosis or did not have their CTI or DD levels assessed were excluded. We categorized patients according to the previous algorithm and compared the outcomes with the previous test dataset. Results The analysis involved data from 156 patients with APTE and 363 patients with NSTEMI. In the validation data set, the APTE group showed higher initial DD levels (9.80±10.84 μg/mL) and lower initial CTI levels (0.17±0.54 μg/mL) than the NSTEMI group. The accuracy rate for the test dataset and the validation set were similar. The test set accuracy rate was 91.0%, while the accuracy rate in the validation set improved to 88.6%. Conclusions Patients with APTE exhibited lower initial and peak CTI levels, but higher DD levels than NSTEMI patients. The accuracy rate estimates were similar between the test set obtained from the tree model algorithm and the validation set. The study findings demonstrate that the assessment of cardiac biomarkers can be useful for differentiating between APTE and NSTEMI.http://www.kosinmedj.org/upload/pdf/kmj-23-133.pdfmyocardial infarctionpulmonary embolismtroponin i |
| spellingShingle | Soo-Jin Kim Moo Hyun Kim Kwang Min Lee Jin Woo Lee Young Shin Cha Da Eun Koh Joo Yeong Hwang Jong Sung Park Troponin I and D-dimer levels as triaging biomarkers to distinguish acute pulmonary thromboembolism from myocardial infarction Kosin Medical Journal myocardial infarction pulmonary embolism troponin i |
| title | Troponin I and D-dimer levels as triaging biomarkers to distinguish acute pulmonary thromboembolism from myocardial infarction |
| title_full | Troponin I and D-dimer levels as triaging biomarkers to distinguish acute pulmonary thromboembolism from myocardial infarction |
| title_fullStr | Troponin I and D-dimer levels as triaging biomarkers to distinguish acute pulmonary thromboembolism from myocardial infarction |
| title_full_unstemmed | Troponin I and D-dimer levels as triaging biomarkers to distinguish acute pulmonary thromboembolism from myocardial infarction |
| title_short | Troponin I and D-dimer levels as triaging biomarkers to distinguish acute pulmonary thromboembolism from myocardial infarction |
| title_sort | troponin i and d dimer levels as triaging biomarkers to distinguish acute pulmonary thromboembolism from myocardial infarction |
| topic | myocardial infarction pulmonary embolism troponin i |
| url | http://www.kosinmedj.org/upload/pdf/kmj-23-133.pdf |
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