Can High-Sensitive Troponin T Be Used in the Diagnosis of Pulmonary Embolism? Retrospective Analysis
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Abstract
Aim: Identifying cardiac and noncardiac causes is important in patients followed up in the emergency department for chest pain, shortness of breath, palpitation, syncope, and cardiopulmonary arrest. One noncardiac cause is pulmonary embolism. In this situation, troponin levels increase, as in cardiac causes, which is important for diagnosis. We aimed to retrospectively determine whether a correlation exists between troponin levels and embolism degree in blood samples obtained from patients with embolism.
Materials and Methods: This study is retrospective. Patients >18 years who had increased troponin levels and underwent pulmonary computed tomography angiography (PCTA) in the critical area of a training and research hospital between June 2020 and June 2022 were included in the study.
Results: Of the 274 patients included in our study, 45.3% were male. The most common presenting symptom (274 patients) was dyspnea (46.0%). Of the CT scans obtained for diagnostic purposes, 71.5% were interpreted as normal while the remainder showed positive embolism findings. Chest pain was lower in patients with high troponin levels (p=0.002). CT findings were more common in patients with low troponin levels (p=0.034). Chest pain was observed more frequently in discharged patients (p=0.029). The CT findings of the discharged patients were normal (p<0.001); bilateral, lobar, and segmental incidences were lower than those of the undischarged patients (p=0.022, p=0.003, p=0.037, and p<0.05, respectively).
Conclusion: No significant relationship was noted between troponin levels and embolism. No significant relationship was found between embolism diagnosis and hospitalization, although a significant relationship exists between age and increase in troponin level.