TY - JOUR
T1 - Limited value of novel pulmonary embolism biomarkers in patients with coronary atherosclerosis
AU - Borgwardt, Henrik Gutte
AU - Mortensen, Jann
AU - Hag, Anne Mette Fisker
AU - Jensen, Claus V
AU - Kristoffersen, Ulrik S
AU - Brinth, Louise
AU - Kjaer, Andreas
N1 - © 2011 The Authors. Clinical Physiology and Functional Imaging © 2011 Scandinavian Society of Clinical Physiology and Nuclear Medicine.
PY - 2011/11/1
Y1 - 2011/11/1
N2 - Background: Recent research supports the efficacy of various plasma biomarkers in diagnosing pulmonary embolism (PE) including E-selectin, MMP-9, MPO, sVCAM-1, sICAM-1, adiponectin, hs-CRP and tPAI-1. Objective: We hypothesized that these biomarkers, which are affected in both venous and arterial thromboembolic diseases, have a limited potential of diagnosing PE in patients with concomitant coronary atherosclerosis, as assessed from a low-dose CT scan of the thorax, compared to patients without atherosclerosis. Methods: Consecutive patients suspected of PE were referred. All patients had a ventilation/perfusion single photon emission tomography (V/Q-SPECT), low-dose pulmonary CT, pulmonary multidetector computer tomography angiography, blood samples and ECG-gated cardiac CT performed the same day. Results: A total of 69 patients were included, of which 28 (41%) had PE. In patients without coronary calcium, MMP-9 and tPAI-1 were significantly elevated (P<0·042 and P<0·049) in patients diagnosed with PE. From the receiver operating curves, we chose a cut-off value for MMP-9 at 164·4ngl -1, which yielded sensitivity, specificity, positive and negative predictive values of 63%, 78%, 71% and 70%, respectively. With a chosen cut-off value for tPAI-1 at 56·3ngl -1, the sensitivity, specificity, positive and negative predictive values were 88%, 89%, 88% and 89%, respectively. In patients with coronary calcium, none of the biomarkers could discriminate between PE and no PE. Conclusion: Plasma levels of tPAI-1 and MMP-9 are potentially useful in patients suspected of PE, however, not in the presence of the coronary atherosclerosis.
AB - Background: Recent research supports the efficacy of various plasma biomarkers in diagnosing pulmonary embolism (PE) including E-selectin, MMP-9, MPO, sVCAM-1, sICAM-1, adiponectin, hs-CRP and tPAI-1. Objective: We hypothesized that these biomarkers, which are affected in both venous and arterial thromboembolic diseases, have a limited potential of diagnosing PE in patients with concomitant coronary atherosclerosis, as assessed from a low-dose CT scan of the thorax, compared to patients without atherosclerosis. Methods: Consecutive patients suspected of PE were referred. All patients had a ventilation/perfusion single photon emission tomography (V/Q-SPECT), low-dose pulmonary CT, pulmonary multidetector computer tomography angiography, blood samples and ECG-gated cardiac CT performed the same day. Results: A total of 69 patients were included, of which 28 (41%) had PE. In patients without coronary calcium, MMP-9 and tPAI-1 were significantly elevated (P<0·042 and P<0·049) in patients diagnosed with PE. From the receiver operating curves, we chose a cut-off value for MMP-9 at 164·4ngl -1, which yielded sensitivity, specificity, positive and negative predictive values of 63%, 78%, 71% and 70%, respectively. With a chosen cut-off value for tPAI-1 at 56·3ngl -1, the sensitivity, specificity, positive and negative predictive values were 88%, 89%, 88% and 89%, respectively. In patients with coronary calcium, none of the biomarkers could discriminate between PE and no PE. Conclusion: Plasma levels of tPAI-1 and MMP-9 are potentially useful in patients suspected of PE, however, not in the presence of the coronary atherosclerosis.
U2 - 10.1111/j.1475-097x.2011.01043.x
DO - 10.1111/j.1475-097x.2011.01043.x
M3 - Journal article
SN - 1475-0961
VL - 31
SP - 452
EP - 457
JO - Clinical Physiology and Functional Imaging
JF - Clinical Physiology and Functional Imaging
IS - 6
ER -