ERRATUM TO: Cardiac Troponins in Low-Risk Pulmonary Embolism Patients: A Systematic Review and Meta-Analysis

Omar S Darwish1, Abdullah Mahayni2, Mukti Patel3

  • 1University of California, Irvine, UCI Medical Center, Orange, California, USA. odarwish@uci.edu.

Insights

Cardiac troponin levels in low-risk pulmonary embolism patients are assessed. Elevated troponin indicates a higher risk of mortality, while negative troponin suggests a lower risk, aiding clinical decisions.

Area of Science:

  • Cardiology
  • Pulmonary Medicine
  • Diagnostic Biomarkers

Background:

  • Pulmonary embolism (PE) is a critical condition requiring accurate risk stratification.
  • Cardiac troponins are established biomarkers for myocardial injury.
  • Assessing the prognostic value of troponins in low-risk PE is crucial for guiding management.

Purpose of the Study:

  • To systematically review and meta-analyze the diagnostic and prognostic accuracy of cardiac troponins in patients with low-risk pulmonary embolism.
  • To determine the predictive value of troponin levels for all-cause mortality in this patient cohort.

Main Methods:

  • Systematic review and meta-analysis of published studies.
  • Inclusion of studies reporting troponin levels and clinical outcomes in low-risk PE patients.
  • Pooled analysis of diagnostic performance metrics including positive and negative likelihood ratios (LRs), positive and negative predictive values (PPVs and NPVs), and odds ratios (ORs).

Main Results:

  • The pooled positive likelihood ratio (LR) for all-cause mortality was 2.04 (95% CI, 1.53 to 2.72), and the negative LR was 0.72 (95% CI, 0.37 to 1.40).
  • In the pooled data, 33% of patients tested positive for troponin, and the overall mortality was 1.2%.
  • The overall negative predictive value (NPV) was approximately 1, indicating high reliability in ruling out mortality. The overall positive predictive values (PPVs) were low, ranging from 0 to 0.60.

Conclusions:

  • Cardiac troponin testing demonstrates prognostic value in low-risk pulmonary embolism patients.
  • A negative troponin result is highly reliable for excluding mortality (NPV ≈ 1).
  • Elevated troponin levels are associated with an increased risk of all-cause mortality, though with low positive predictive value.

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