Tanabe Yasuhiro, Obayashi Toru, Yamamoto Takeshi, Takayama Morimasa, Nagao Ken
Tokyo CCU Network Scientific Committee, Tokyo, Japan.
Tokyo CCU Network Scientific Committee, Tokyo, Japan.
J Cardiol. 2015 Dec;66(6):460-5. doi: 10.1016/j.jjcc.2015.03.002. Epub 2015 Apr 2.
Several studies from Western countries have reported associations between cardiac troponin and B-type natriuretic peptide (BNP) levels and acute pulmonary embolism prognosis; however, the number of such reports from Asian countries, including Japan, is limited. Thus, we evaluated the relationship between blood biochemical findings and acute-phase pulmonary embolism prognosis in Japanese patients.
The subjects included 441 patients with acute pulmonary embolism (191 men, 250 women; average age, 65.8±16.0 years) treated at Tokyo CCU Network Institutions from 2009 to 2011 and registered via survey forms. The association between blood biochemical findings at admission and 30-day mortality was investigated.
The median BNP value was 186.5pg/mL (25th to 75th interquartile range: 49.8-500pg/mL) of 210 cases. No deaths were recorded among those with BNP levels <90pg/mL (n=70), whereas significantly higher mortality (10 deaths/140 cases, 7.1%; p=0.033) was observed among those with BNP levels ≥90pg/mL. A qualitative cardiac troponin test was positive in 58 of the 204 cases (28.4%), with a significantly higher mortality incidence (p=0.017) among the troponin-positive cases [6 (10.3%) versus 3 (2.1%) deaths among the 146 troponin-negative cases]. The overall mean blood glucose level at admission of 331 cases was 152.0±74.0mg/dL, and 30-day mortality significantly increased with blood glucose values (p=0.048).
Troponin, BNP, and blood glucose levels are useful prognostic biomarkers for acute pulmonary embolism in Japanese patients.
西方国家的多项研究报告了心肌肌钙蛋白和B型利钠肽（BNP）水平与急性肺栓塞预后之间的关联；然而，包括日本在内的亚洲国家的此类报告数量有限。因此，我们评估了日本患者血液生化检查结果与急性期肺栓塞预后之间的关系。
研究对象包括2009年至2011年在东京CCU网络机构接受治疗并通过调查问卷形式登记的441例急性肺栓塞患者（男性191例，女性250例；平均年龄65.8±16.0岁）。研究了入院时血液生化检查结果与30天死亡率之间的关联。
210例患者的BNP中位数为186.5pg/mL（第25至75四分位数间距：49.8 - 500pg/mL）。BNP水平<90pg/mL的患者（n = 70）无死亡记录，而BNP水平≥90pg/mL的患者死亡率显著更高（10例死亡/140例，7.1%；p = 0.033）。204例患者中有58例（28.4%）定性心肌肌钙蛋白检测呈阳性，肌钙蛋白阳性患者的死亡率显著更高（p = 0.017）[146例肌钙蛋白阴性患者中有3例（2.1%）死亡，而肌钙蛋白阳性患者中有6例（10.3%）死亡]。331例患者入院时的总体平均血糖水平为152.0±74.0mg/dL，30天死亡率随血糖值显著增加（p = 0.048）。
肌钙蛋白、BNP和血糖水平是日本急性肺栓塞患者有用的预后生物标志物。
