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Establishment of a Minimally Invasive Rat Model of Pulmonary Embolism Using Autologous Blood Clots
Published on: October 25, 2024
Risk Stratification in Pulmonary Embolism: The Expanding Role of Biomarkers
Cyrus Moini1, Piseth Lay1, Sebastien Jochmans2
1Cardiology Department, Groupe Hospitalier Sud-Ile de France, 270 Avenue Marc Jacquet, 77000 Melun, France.
Biomedicines
|May 27, 2026
Summary
Accurate prognostic assessment for pulmonary embolism (PE) is crucial. This review explores established and emerging biomarkers, including troponins and natriuretic peptides, to refine risk stratification and personalize patient care.
Area of Science:
- Cardiology
- Pulmonology
- Biomarker Research
Background:
- Pulmonary embolism (PE) is a frequent, potentially fatal condition where early mortality is driven by right ventricular (RV) failure and hemodynamic collapse.
- Accurate prognostic assessment is critical for effective PE management, guiding treatment intensity and escalation strategies.
- Current European Society of Cardiology (ESC) guidelines utilize hemodynamic status, clinical risk scores (HESTIA, PESI/sPESI), RV imaging, and biomarkers for risk stratification.
Purpose of the Study:
- To provide a practical overview of established and emerging biomarkers for pulmonary embolism (PE) risk stratification.
- To highlight the expanding role of biomarkers in refining prognosis, particularly within the heterogeneous intermediate-risk PE group.
- To discuss future directions in multimodal and omics-driven biomarker profiling for personalized PE care.
Main Methods:
- Review of established and emerging biomarkers for PE risk stratification.
- Analysis of conventional cardiac biomarkers (troponins, natriuretic peptides) and their role in conjunction with RV dysfunction.
- Exploration of novel biomarkers including copeptin, H-FABP, GDF-15, lactate, microRNAs, inflammatory indices (NLR, PLR, LMR), red cell distribution width, and hs-CRP.
Main Results:
- Conventional cardiac biomarkers (troponins, BNP/NT-proBNP) reflect RV myocardial injury and strain, aiding discrimination in intermediate-risk PE when combined with imaging.
- D-dimer has a primary diagnostic role but an adjunctive prognostic role in PE.
- Emerging biomarkers target complementary pathways such as neurohormonal stress, myocardial injury, inflammation, hypoxia, and tissue hypoperfusion, showing potential for refined risk stratification.
Conclusions:
- Biomarkers play an expanding role in refining PE prognosis, especially in intermediate-risk patients.
- Multimodal biomarker approaches, integrated with advanced imaging, are essential for precise, dynamic, and personalized PE management.
- Future research should focus on omics-driven profiling for improved acute risk prediction, long-term follow-up, and prevention of chronic complications.
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