Observational studyJournal of the American Heart Association2025
Predicting Deterioration in Patients With Normotensive Acute Pulmonary Embolism Using Clinical-Imaging Features: A Multicenter Prospective Cohort Study.
Observational study in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05098769 (A Predictive Tool for Predicting Adverse Outcomes in Acute Pulmonary Embolism Patients Using Parameters Obtained by Computed Tomographic Pulmonary Angiography.), which is not on this map. Cited by 2 papers.
What it found
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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.
The trial behind it
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A Predictive Tool for Predicting Adverse Outcomes in Acute Pulmonary Embolism Patients Using Parameters Obtained by Computed Tomographic Pulmonary Angiography.
Who cites it
2 citing papers in PubMed.
- Admission Endothelial Activation and Stress Index and Echocardiographic RV-PA Coupling for Early Risk Stratification in Intermediate-Risk Acute Pulmonary Embolism.Journal of clinical medicine · 2026Article
- Imaging-Driven Risk Stratification and Endovascular Decision Pathways in Acute Pulmonary Embolism.Diagnostics (Basel, Switzerland) · 2026Review
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrioritization of management strategies in patients with normotensive acute pulmonary embolism is based on the identification of individuals at risk for early deterioration. This study aims to develop and validate a novel score for deterioration prediction using clinical-imaging features.
methodsThis is multicenter, prospective observational cohort study (AOAPECT [Adverse Outcomes in Acute Pulmonary Embolism patients using Computed Tomography pulmonary angiography] cohort, NCT05098769). Registered-enrolled patients with normotensive acute pulmonary embolism were collected consecutively from 5 centers across China. Derivation set was established from 2 centers, while local and nonlocal external validation sets were derived from the remaining 3 centers. The end point was pulmonary embolism-related deterioration within 30 days after admission. Deterioration-related candidate predictors consisted of clinical, laboratory and computed tomography pulmonary angiography parameters were screened and then split into dichotomous values. The predictive score was conducted by a multivariable logistics regression and validated. Score performances were quantified using the area under the receiver operating characteristic curve.
resultsOf 3310 enrolled patients including 1 derivation (n=2061) and 2 validation sets (n=969 and 280), 272 patients (8.2%) experienced deterioration. In the derivation set, an increased risk of deterioration was observed with right to left ventricle diameter ratio ≥1.2, appearance of pulmonary vein sign on computed tomography pulmonary angiography, and heart rate ≥110 beats/min. When at least 2 out of 3 items were positive, patients were assigned to the high-risk deterioration group. This PE-RPH score revealed good discrimination to deterioration in derivation and validation sets (area under the receiver operating characteristic curve, 0.82, 0.82, and 0.80).
conclusionsThis PE-RPH score incorporating 2 computed tomography pulmonary angiography parameters and heart rate may help predict the deterioration risk in patients with normotensive acute pulmonary embolism. REGISTRATION: https://clinicaltrials.gov; identifier: NCT05098769.
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