BACKGROUND: Prognostic stratification of patients with acute pulmonary embolism (PTE) is crucial in identifying patients who would benefit from more aggressive treatment. We aimed to examine the value of ST elevation in lead aVR (STEaVR ) in predicting hospital mortality following PTE. MATERIALS: Two hundred patients with a diagnosis of PTE were allocated into two groups based on the presence or absence of STEaVR . Multivariate logistic regression analysis was used to investigate the role of "STEaVR " in relation to the other risk factors in predicting prognosis of PTE. RESULTS: Out of 200 patients, 24 (12.0%) had STEaVR . Patients with STEaVR were more likely to present with hypotension and tachycardia than those who did not have this electrocardiographic finding. A total of 33.3% of patients with STEaVR and 13.1% of those without STEaVR died during hospitalization. STEaVR had a low sensitivity of 25.8% but a high specificity of 90.5% for predicting hospital mortality. Odds ratio for hospital mortality was 3.32 for STEaVR with 95% confidence interval of 1.28-8.64 (P = 0.017) in univariate analysis. In multivariate analysis shock was the strongest predictor of hospital mortality. CONCLUSION: The presence of STEaVR is indicative of hemodynamic instability, thereby having the ability to predict poor outcome. However, its impact on hospital mortality disappears when the presence of shock on admission is factored in the prediction model.
BACKGROUND: Prognostic stratification of patients with acute pulmonary embolism (PTE) is crucial in identifying patients who would benefit from more aggressive treatment. We aimed to examine the value of ST elevation in lead aVR (STEaVR ) in predicting hospital mortality following PTE. MATERIALS: Two hundred patients with a diagnosis of PTE were allocated into two groups based on the presence or absence of STEaVR . Multivariate logistic regression analysis was used to investigate the role of "STEaVR " in relation to the other risk factors in predicting prognosis of PTE. RESULTS: Out of 200 patients, 24 (12.0%) had STEaVR . Patients with STEaVR were more likely to present with hypotension and tachycardia than those who did not have this electrocardiographic finding. A total of 33.3% of patients with STEaVR and 13.1% of those without STEaVR died during hospitalization. STEaVR had a low sensitivity of 25.8% but a high specificity of 90.5% for predicting hospital mortality. Odds ratio for hospital mortality was 3.32 for STEaVR with 95% confidence interval of 1.28-8.64 (P = 0.017) in univariate analysis. In multivariate analysis shock was the strongest predictor of hospital mortality. CONCLUSION: The presence of STEaVR is indicative of hemodynamic instability, thereby having the ability to predict poor outcome. However, its impact on hospital mortality disappears when the presence of shock on admission is factored in the prediction model.
Authors: Piotr Kukla; Robert Długopolski; Ewa Krupa; Romana Furtak; Roman Szełemej; Ewa Mirek-Bryniarska; Marek Jastrzębski; Jacek Nowak; Piotr Wańczura; Leszek Bryniarski Journal: Cardiol J Date: 2011 Impact factor: 2.737
Authors: Stavros V Konstantinides; Adam Torbicki; Giancarlo Agnelli; Nicolas Danchin; David Fitzmaurice; Nazzareno Galiè; J Simon R Gibbs; Menno V Huisman; Marc Humbert; Nils Kucher; Irene Lang; Mareike Lankeit; John Lekakis; Christoph Maack; Eckhard Mayer; Nicolas Meneveau; Arnaud Perrier; Piotr Pruszczyk; Lars H Rasmussen; Thomas H Schindler; Pavel Svitil; Anton Vonk Noordegraaf; Jose Luis Zamorano; Maurizio Zompatori Journal: Eur Heart J Date: 2014-08-29 Impact factor: 29.983
Authors: Piotr Kukla; William F McIntyre; Kamil Fijorek; Ewa Mirek-Bryniarska; Leszek Bryniarski; Ewa Krupa; Marek Jastrzębski; Krzysztof L Bryniarski; Zhan Zhong-qun; Adrian Baranchuk Journal: Am J Emerg Med Date: 2014-02-03 Impact factor: 2.469
Authors: J Trujillo-Santos; P L den Exter; V Gómez; H Del Castillo; C Moreno; T van der Hulle; M V Huisman; M Monreal; R D Yusen; D Jiménez Journal: J Thromb Haemost Date: 2013-10 Impact factor: 5.824
Authors: Piotr Kukla; William F McIntyre; Kamil Fijorek; Ewa Krupa; Ewa Mirek-Bryniarska; Marek Jastrzębski; Krzysztof L Bryniarski; Wiktor Zajchowski; Leszek Bryniarski; Adrian Baranchuk Journal: Am J Emerg Med Date: 2014-08-02 Impact factor: 2.469