Evidence map›Paper›PMID 36837387›Full record

ArticleMedicina (Kaunas, Lithuania)2023

Utility of Combining High-Sensitive Cardiac Troponin I and PESI Score for Risk Management in Patients with Pulmonary Embolism in the Emergency Department.

Elisa Cennamo, Gabriele Valli, Engy Khaled Mohamed Riead, Silvia Casalboni, Ilaria Dafne Papasidero, Francesca De Marco, Anna Mariani, Paola Pepe, Giuseppe Santangelo, Marina Mastracchi and 5 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Medicina (Kaunas, Lithuania), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. The Prognostic Value of Troponin in Acute Pulmonary Embolism: A Systematic Review and Meta-Analysis.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2025
    Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 3 institutions in 1 country.

Elisa CennamoPostgraduate School of Emergency Medicine, Faculty of Medicine and Psychology, University of Rome La Sapienza, 00185 Rome, Italy.ORCID 0000-0002-1046-8892
Gabriele ValliEmergency Department, San Giovanni Addolorata Hospital, 00184 Rome, Italy.ORCID 0000-0003-0576-6104
Engy Khaled Mohamed RieadPostgraduate School of Emergency Medicine, Faculty of Medicine and Psychology, University of Rome La Sapienza, 00185 Rome, Italy.
Silvia CasalboniPostgraduate School of Emergency Medicine, Faculty of Medicine and Psychology, University of Rome La Sapienza, 00185 Rome, Italy.
Ilaria Dafne PapasideroPostgraduate School of Emergency Medicine, Faculty of Medicine and Psychology, University of Rome La Sapienza, 00185 Rome, Italy.ORCID 0000-0002-2097-1491
Francesca De MarcoEmergency Department, San Giovanni Addolorata Hospital, 00184 Rome, Italy.
Anna MarianiPostgraduate School of Emergency Medicine, Faculty of Medicine and Psychology, University of Rome La Sapienza, 00185 Rome, Italy.
Paola PepePostgraduate School of Emergency Medicine, Faculty of Medicine and Psychology, University of Rome La Sapienza, 00185 Rome, Italy.
Giuseppe SantangeloPostgraduate School of Emergency Medicine, Faculty of Medicine and Psychology, University of Rome La Sapienza, 00185 Rome, Italy.
Marina MastracchiPostgraduate School of Emergency Medicine, Faculty of Medicine and Psychology, University of Rome La Sapienza, 00185 Rome, Italy.
Paolo FratiniPostgraduate School of Emergency Medicine, Faculty of Medicine and Psychology, University of Rome La Sapienza, 00185 Rome, Italy.
Giacinta PistilliPostgraduate School of Emergency Medicine, Faculty of Medicine and Psychology, University of Rome La Sapienza, 00185 Rome, Italy.
Pasquale PignatelliDepartment of Internistic, Anesthesiologic and Cardiovascular Clinical Sciences, University of Rome La Sapienza, 00185 Rome, Italy.ORCID 0000-0002-2265-7455
Maria Pia RuggieriEmergency Department, San Giovanni Addolorata Hospital, 00184 Rome, Italy.
Salvatore Di SommaPostgraduate School of Emergency Medicine, Faculty of Medicine and Psychology, University of Rome La Sapienza, 00185 Rome, Italy.
Sapienza University of Rome · ITAzienda Ospedaliera San Giovanni Addolorata · ITWorld Health Organization - Italy · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesPulmonary embolism (PE) has a major burden of morbidity and mortality, consequently the need for a prompt risk stratification for these subjects is crucial. In order to evaluate the risk management and final disposition of patients with PE in the Emergency Department (ED), we conducted a study that was divided in two phases: Phase I retrospective study (RS), Phase II prospective study (PS). MATERIALS AND

methodsIn Phase I, 291 patients were enrolled while in Phase II, 83 subjects were evaluated. In both study phases, the enrolled subjects were analyzed for final disposition in ED using PESI score, right ventricle (RV) imaging, and high-sensitive cardiac troponin I (hs-cTnI) data. The RS patients were divided into low risk and high risk according to the sPESI score, while PS patients were grouped in low, intermediate, and high risk classes according to PESI score. In both study phases, all the studied patients were further divided into negative (hs-cTnI-) or positive (hs-cTnI+) groups according to hs-cTnI levels within normal or above cutoff values, respectively. For all enrolled subjects, CT pulmonary angiography was analyzed to assess the RV/LV diameter and volume ratio as an indicator of RV involvement.

resultsIn both RS and PS phases, hs-cTnI+ group showed a higher PESI score. Nevertheless, a significant percentage of hs-cTnI+ patients resulted to be in the low-risk PESI class. Patients with a positive RV/LV ratio were more likely to have a hs-cTnI+ (p < 0.01), while among those with a negative ratio, 24 to 32% showed as hs-cTnI+. In the hs-cTnI+ group from both study phases, patients were more likely to be admitted in an ICU (RR 3.7, IC: 2.1-6.5).

conclusionsIn conclusion, in patients with PE in the ED compared PESI score alone, the combination of hs-cTnI and PESI seems to be of greater utility in improving risk stratification and final disposition decision-making.

Indexed as

Pulmonary EmbolismTroponin IBiomarkersEmergency Service, HospitalHumansPredictive Value of TestsPrognosisProspective StudiesRetrospective StudiesRisk AssessmentRisk ManagementBiomarkersTroponin Iemergency departmentfinal dispositionhigh-sensitive cardiac Troponin IPESI scorepulmonary embolismrisk assessment

Identifiers

PMID36837387
PMCPMC9968180
OpenAlexW4316806122

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.