Evidence map›Paper›PMID 42193372›Full record

ReviewBiomedicines2026

Risk Stratification in Pulmonary Embolism: The Expanding Role of Biomarkers.

Cyrus Moini, Piseth Lay, Sebastien Jochmans, Fidele Azandjo, Nassima El Karroumi, Anne-Laure Bouilland, El Mahdi Hafiani

Abstract readReview
In one paragraph

Review in Biomedicines, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

7 authors.

Cyrus MoiniCardiology Department, Groupe Hospitalier Sud-Ile de France, 270 Avenue Marc Jacquet, 77000 Melun, France.ORCID 0000-0001-7237-6064
Piseth LayCardiology Department, Groupe Hospitalier Sud-Ile de France, 270 Avenue Marc Jacquet, 77000 Melun, France.
Sebastien JochmansDepartment of Intensive Care Medicine, Groupe Hospitalier Sud Ile de France, 270 Avenue Marc Jacquet, 77000 Melun, France.ORCID 0000-0002-7111-4107
Fidele AzandjoCardiology Department, Groupe Hospitalier Sud-Ile de France, 270 Avenue Marc Jacquet, 77000 Melun, France.
Nassima El KarroumiCardiology Department, Groupe Hospitalier Sud-Ile de France, 270 Avenue Marc Jacquet, 77000 Melun, France.
Anne-Laure BouillandDepartment of Intensive Care Medicine, Groupe Hospitalier Sud Ile de France, 270 Avenue Marc Jacquet, 77000 Melun, France.
El Mahdi HafianiDepartment of Anesthesia and Perioperative Medecine, Private Hospital of Antony, 1 Rue Velpeau, 92160 Antony, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Pulmonary embolism (PE) remains a frequent and potentially fatal condition, with early mortality largely driven by (RV) failure and hemodynamic collapse. Rapid and accurate prognostic assessment is therefore central to management. Current European Society of Cardiology (ESC) strategies rely first on hemodynamic status to identify high-risk patients requiring urgent reperfusion consideration, and then-when patients are normotensive-on a stepwise approach combining clinical risk scores, RV imaging, and circulating biomarkers. Clinical tools such as HESTIA and the Pulmonary Embolism Severity Index (PESI)/simplified PESI (sPESI) enable early identification of low-risk patients suitable for outpatient pathways and stratify 30-day mortality risk, but do not integrate biological data. Consequently, biomarkers have an expanding role in refining prognosis, particularly within the heterogeneous intermediate-risk group. This review provides a practical overview of established and emerging biomarkers for PE risk stratification. Conventional cardiac biomarkers-troponins and natriuretic peptides (BNP/NT-proBNP)-reflect RV myocardial injury and strain and, when combined with imaging evidence of RV dysfunction, allow discrimination between intermediate-low- and intermediate-high-risk PE, guiding monitoring intensity and escalation strategies. D-dimer, while essential in diagnostic algorithms because of its high negative predictive value, has only an adjunctive and indirect prognostic role. Beyond these markers, growing evidence supports additional biomarkers capturing complementary pathways: neurohormonal stress (copeptin), early myocardial injury (H-FABP), inflammation and hypoxia (GDF-15), tissue hypoperfusion (lactate), and molecular regulation (circulating microRNAs). Readily available inflammatory indices derived from blood counts (NLR, PLR, LMR), red cell distribution width, and hs-CRP may further contribute within multimarker models, although specificity and validation remain limitations. Future directions include multimodal and omics-driven biomarker profiling integrated with advanced imaging to enable more precise, dynamic, and personalized PE care, from acute risk prediction to long-term follow-up and prevention of chronic thromboembolic complications.

Indexed as

biomarkersBNP/NT-proBNPcopeptinD-dimerheart-type fatty acid-binding protein (H-FABP)inflammatory biomarkerslactatemicroRNAsprognosispulmonary embolismrisk stratificationtroponin

Identifiers

PMID42193372
PMCPMC13205043

What OpenQuestion holds

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Registered trials

None linked

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.