(Circulation. 2000;102:211.)
© 2000 American Heart Association, Inc.
Clinical Investigation and Reports |
Independent Prognostic Value of Cardiac Troponin T in Patients With Confirmed Pulmonary Embolism
From Medizinische Klinik II, Medizinische Universität zu Lübeck, Germany.
Correspondence to Prof Hugo A Katus, Medizinische Klinik II, Medizinische Universität zu Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany. E-mail giannits{at}medinf.mu-luebeck.de
Background—Cardiac troponin T (cTnT) is a sensitive and specific marker, allowing the detection of even minor myocardial cell injury. In patients with severe pulmonary embolism (PE), myocardial ischemia may lead to progressive right ventricular dysfunction. It was therefore the purpose of this study to test the presence of cTnT and its prognostic implications in patients with confirmed PE.
Methods and Results—Fifty-six consecutive patients with confirmed
PE were enrolled in this prospective study. PE was confirmed by
pulmonary angiography, lung scan, or
echocardiography and subsidiary analyses.
Severity of PE was assessed by a clinical scoring system, and cTnT was
measured within 12 hours after admission. cTnT was elevated (
0.1
µg/L) in 18 (32%) patients with massive and moderate PE but not in
patients with small PE. In-hospital death (odds ratio 29.6, 95% CI 3.3
to 265.3), prolonged hypotension and cardiogenic shock (odds ratio
11.4, 95% CI 2.1 to 63.4), and need for resuscitation (odds ratio
18.0, 95% CI 2.6 to 124.3) were more prevalent in patients with
elevated cTnT. cTnT-positive patients more often needed inotropic
support (odds ratio 37.6, 95% CI 5.8 to 245.6) and mechanical
ventilation (odds ratio 78.8, 95% CI 9.5 to 653.2). After adjustment,
cTnT remained an independent predictor of 30-day mortality (odds ratio
15.2, 95% CI 1.22 to 190.4).
Conclusions—cTnT may improve risk stratification in patients with PE and may aid in the identification of patients in whom a more aggressive therapy may be warranted.
Key Words: embolism • pulmonary heart disease • coronary disease
This article has been cited by other articles:
 |
|
 |
|
  D. Jimenez, F. Uresandi, R. Otero, J. L. Lobo, M. Monreal, D. Marti, J. Zamora, A. Muriel, D. Aujesky, and R. D. Yusen Troponin-Based Risk Stratification of Patients With Acute Nonmassive Pulmonary Embolism: Systematic Review and Metaanalysis Chest, October 1, 2009; 136(4): 974 - 982. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. L. Todd and V. F. Tapson Thrombolytic Therapy for Acute Pulmonary Embolism: A Critical Appraisal Chest, May 1, 2009; 135(5): 1321 - 1329. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Authors/Task Force Members, A. Torbicki, A. Perrier, S. Konstantinides, G. Agnelli, N. Galie, P. Pruszczyk, F. Bengel, A. J.B. Brady, D. Ferreira, et al. Guidelines on the diagnosis and management of acute pulmonary embolism: The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC) Eur. Heart J., September 2, 2008; 29(18): 2276 - 2315. [Full Text] [PDF]
|
|
|
|
 |
|
 D. Jimenez, G. Diaz, J. Molina, D. Marti, J. Del Rey, S. Garcia-Rull, C. Escobar, R. Vidal, A. Sueiro, and R. D. Yusen Troponin I and risk stratification of patients with acute nonmassive pulmonary embolism Eur. Respir. J., April 1, 2008; 31(4): 847 - 853. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Wolfe Barry, J. H. Barth, and S. J. Howell Cardiac troponins: their use and relevance in anaesthesia and critical care medicine CEACCP, April 1, 2008; 8(2): 62 - 66. [Full Text] [PDF]
|
|
|
|
 |
|
 M P V Begieneman, F R W van de Goot, I A C van der Bilt, A V. Noordegraaf, M D Spreeuwenberg, W J Paulus, V W M van Hinsbergh, F C Visser, and H W M Niessen Pulmonary embolism causes endomyocarditis in the human heart Heart, April 1, 2008; 94(4): 450 - 456. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Fremont, G. Pacouret, D. Jacobi, R. Puglisi, B. Charbonnier, and A. de Labriolle Prognostic Value of Echocardiographic Right/Left Ventricular End-Diastolic Diameter Ratio in Patients With Acute Pulmonary Embolism*: Results From a Monocenter Registry of 1,416 Patients Chest, February 1, 2008; 133(2): 358 - 362. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. T. Lu, T. Cai, H. Ersoy, A. G. Whitmore, R. Quiroz, S. Z. Goldhaber, and F. J. Rybicki Interval Increase in Right-Left Ventricular Diameter Ratios at CT as a Predictor of 30-day Mortality after Acute Pulmonary Embolism: Initial Experience Radiology, January 1, 2008; 246(1): 281 - 287. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 NACB WRITING GROUP MEMBERS, A. H.B. Wu, A. S. Jaffe, F. S. Apple, R. L. Jesse, G. L. Francis, D. A. Morrow, L. K. Newby, J. Ravkilde, W.H. W. Tang, et al. National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: Use of Cardiac Troponin and B-Type Natriuretic Peptide or N-Terminal proB-Type Natriuretic Peptide for Etiologies Other than Acute Coronary Syndromes and Heart Failure Clin. Chem., December 1, 2007; 53(12): 2086 - 2096. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Palmieri, E. A. Palmieri, and A. Celentano Functional limitation and right ventricular dysfunction at 6-month follow-up in patients with non-massive pulmonary embolism: useful outcomes for testing therapy of acute submassive pulmonary embolism? Eur. Heart J., October 2, 2007; 28(20): 2430 - 2431. [Full Text] [PDF]
|
|
|
|
 |
|
 C. Becattini, M. C. Vedovati, and G. Agnelli Prognostic Value of Troponins in Acute Pulmonary Embolism: A Meta-Analysis Circulation, July 24, 2007; 116(4): 427 - 433. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Alcalai, D. Planer, A. Culhaoglu, A. Osman, A. Pollak, and C. Lotan Acute Coronary Syndrome vs Nonspecific Troponin Elevation: Clinical Predictors and Survival Analysis Arch Intern Med, February 12, 2007; 167(3): 276 - 281. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. J. Perlroth, G. D. Sanders, and M. K. Gould Effectiveness and Cost-effectiveness of Thrombolysis in Submassive Pulmonary Embolism Arch Intern Med, January 8, 2007; 167(1): 74 - 80. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. G. Neilan, J. L. Januzzi, E. Lee-Lewandrowski, T.-T. Ton-Nu, D. M. Yoerger, D. S. Jassal, K. B. Lewandrowski, A. J. Siegel, J. E. Marshall, P. S. Douglas, et al. Myocardial Injury and Ventricular Dysfunction Related to Training Levels Among Nonelite Participants in the Boston Marathon Circulation, November 28, 2006; 114(22): 2325 - 2333. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. H. Madsen, G. Christensen, T. Lund, V. L. Serebruany, C. B. Granger, I. Hoen, Z. Grieg, J. H. Alexander, A. S. Jaffe, J. E. Van Eyk, et al. Time Course of Degradation of Cardiac Troponin I in Patients With Acute ST-Elevation Myocardial Infarction: The ASSENT-2 Troponin Substudy Circ. Res., November 10, 2006; 99(10): 1141 - 1147. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. O. Adesanya, J. A. de Lemos, N. B. Greilich, and C. W. Whitten Management of perioperative myocardial infarction in noncardiac surgical patients. Chest, August 1, 2006; 130(2): 584 - 596. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Korff, H. A Katus, and E. Giannitsis Differential diagnosis of elevated troponins. Heart, July 1, 2006; 92(7): 987 - 993. [Full Text] [PDF]
|
|
|
|
 |
|
 H. Bozbas, A. Yildirir, and H. Muderrisoglu Cardiac enzymes, renal failure and renal transplantation. Clin. Med. Res., March 1, 2006; 4(1): 79 - 84. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Satran, C. R. Henry, and T. D. Henry Reply J. Am. Coll. Cardiol., February 7, 2006; 47(3): 691 - 691. [Full Text] [PDF]
|
|
|
|
|
|
D. Aujesky, P.-M. Roy, C. P. Le Manach, F. Verschuren, G. Meyer, D. S. Obrosky, R. A. Stone, J. Cornuz, and M. J. Fine Validation of a model to predict adverse outcomes in patients with pulmonary embolism Eur. Heart J., February 2, 2006; 27(4): 476 - 481. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. R. Henry, D. Satran, B. Lindgren, C. Adkinson, C. I. Nicholson, and T. D. Henry Myocardial Injury and Long-term Mortality Following Moderate to Severe Carbon Monoxide Poisoning JAMA, January 25, 2006; 295(4): 398 - 402. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Aujesky, D. S. Obrosky, R. A. Stone, T. E. Auble, A. Perrier, J. Cornuz, P.-M. Roy, and M. J. Fine A Prediction Rule to Identify Low-Risk Patients With Pulmonary Embolism Arch Intern Med, January 23, 2006; 166(2): 169 - 175. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Babuin and A. S. Jaffe Troponin: the biomarker of choice for the detection of cardiac injury Can. Med. Assoc. J., November 8, 2005; 173(10): 1191 - 1202. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Aujesky, D. S. Obrosky, R. A. Stone, T. E. Auble, A. Perrier, J. Cornuz, P.-M. Roy, and M. J. Fine Derivation and Validation of a Prognostic Model for Pulmonary Embolism Am. J. Respir. Crit. Care Med., October 15, 2005; 172(8): 1041 - 1046. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Kostrubiec, P. Pruszczyk, A. Bochowicz, R. Pacho, M. Szulc, A. Kaczynska, G. Styczynski, A. Kuch-Wocial, P. Abramczyk, Z. Bartoszewicz, et al. Biomarker-based risk assessment model in acute pulmonary embolism Eur. Heart J., October 2, 2005; 26(20): 2166 - 2172. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Giannitsis and H. A. Katus Risk Stratification in Pulmonary Embolism Based on Biomarkers and Echocardiography Circulation, September 13, 2005; 112(11): 1520 - 1521. [Full Text] [PDF]
|
|
|
|
|
|
L. Binder, B. Pieske, M. Olschewski, A. Geibel, B. Klostermann, C. Reiner, and S. Konstantinides N-Terminal Pro-Brain Natriuretic Peptide or Troponin Testing Followed by Echocardiography for Risk Stratification of Acute Pulmonary Embolism Circulation, September 13, 2005; 112(11): 1573 - 1579. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Piazza and S. Z. Goldhaber The Acutely Decompensated Right Ventricle: Pathways for Diagnosis and Management Chest, September 1, 2005; 128(3): 1836 - 1852. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Jimenez ECG for risk stratification in patients with pulmonary embolism Eur. Respir. J., August 1, 2005; 26(2): 366 - 367. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Thielmann, P. Massoudy, M. Neuhauser, S. Knipp, M. Kamler, G. Marggraf, J. Piotrowski, and H. Jakob Risk stratification with cardiac troponin I in patients undergoing elective coronary artery bypass surgery Eur. J. Cardiothorac. Surg., May 1, 2005; 27(5): 861 - 869. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Spuentrup, A. Buecker, M. Katoh, A. J. Wiethoff, E. C. Parsons Jr, R. M. Botnar, R. M. Weisskoff, P. B. Graham, W. J. Manning, and R. W. Gunther Molecular Magnetic Resonance Imaging of Coronary Thrombosis and Pulmonary Emboli With a Novel Fibrin-Targeted Contrast Agent Circulation, March 22, 2005; 111(11): 1377 - 1382. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. B. Rosalki, R. Roberts, H. A. Katus, E. Giannitsis, J. H. Ladenson, and F. S. Apple Cardiac Biomarkers for Detection of Myocardial Infarction: Perspectives from Past to Present Clin. Chem., November 1, 2004; 50(11): 2205 - 2213. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Landesberg, M. Mosseri, V. Shatz, I. Akopnik, M. Bocher, M. Mayer, H. Anner, Y. Berlatzky, and C. Weissman Cardiac troponin after major vascular surgery: The role of perioperative ischemia, preoperative thallium scanning, and coronary revascularization J. Am. Coll. Cardiol., August 4, 2004; 44(3): 569 - 575. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Macrea, P. Pruszczyk, and A. Torbicki Cardiac Troponin T Monitoring and Acute Pulmonary Embolism Chest, August 1, 2004; 126(2): 655 - 656. [Full Text] [PDF]
|
|
|
|
|
|
M. Panteghini Role and importance of biochemical markers in clinical cardiology Eur. Heart J., July 2, 2004; 25(14): 1187 - 1196. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L La Vecchia, F Ottani, L Favero, G L Spadaro, A Rubboli, C Boanno, G Mezzena, A Fontanelli, and A S Jaffe Increased cardiac troponin I on admission predicts in-hospital mortality in acute pulmonary embolism Heart, June 1, 2004; 90(6): 633 - 637. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Roongsritong, I. Warraich, and C. Bradley Common Causes of Troponin Elevations in the Absence of Acute Myocardial Infarction: Incidence and Clinical Significance Chest, May 1, 2004; 125(5): 1877 - 1884. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. W. Kreit The Impact of Right Ventricular Dysfunction on the Prognosis and Therapy of Normotensive Patients With Pulmonary Embolism Chest, April 1, 2004; 125(4): 1539 - 1545. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Van Mieghem, M. Sabbe, and D. Knockaert The Clinical Value of the ECG in Noncardiac Conditions Chest, April 1, 2004; 125(4): 1561 - 1576. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. S. Gami and A. S. Jaffe 60-Year-Old Man With Chest Pain Mayo Clin. Proc., March 1, 2004; 79(3): 399 - 402. [PDF]
|
|
|
|
 |
|
 S Conroy, I Kamal, and J Cooper Troponin testing: beware pulmonary embolus Emerg. Med. J., January 1, 2004; 21(1): 123 - 124. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Kucher and S. Z. Goldhaber Cardiac Biomarkers for Risk Stratification of Patients With Acute Pulmonary Embolism Circulation, November 4, 2003; 108(18): 2191 - 2194. [Full Text] [PDF]
|
|
|
|
 |
|
 R Castelli, P Tarsia, C Tantardini, G Pantaleo, and A G. F Porro Syncope in patients with pulmonary embolism: comparison between patients with syncope as the presenting symptom of pulmonary embolism and patients with pulmonary embolism without syncope Vascular Medicine, November 1, 2003; 8(4): 257 - 261. [Abstract] [PDF]
|
|
|
|
|
|
P O Collinson and P J Stubbs Are troponins confusing? Heart, November 1, 2003; 89(11): 1285 - 1287. [Full Text] [PDF]
|
|
|
|
|
|
N. Kucher, D. Wallmann, A. Carone, S. Windecker, B. Meier, and O. M. Hess Incremental prognostic value of troponin I and echocardiography in patients with acute pulmonary embolism Eur. Heart J., September 2, 2003; 24(18): 1651 - 1656. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Torbicki, M. Kurzyna, P. Kuca, A. Fijalkowska, J. Sikora, M. Florczyk, P. Pruszczyk, J. Burakowski, and L. Wawrzynska Detectable Serum Cardiac Troponin T as a Marker of Poor Prognosis Among Patients With Chronic Precapillary Pulmonary Hypertension Circulation, August 19, 2003; 108(7): 844 - 848. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. B. Horwich, J. Patel, W. R. MacLellan, and G. C. Fonarow Cardiac Troponin I Is Associated With Impaired Hemodynamics, Progressive Left Ventricular Dysfunction, and Increased Mortality Rates in Advanced Heart Failure Circulation, August 19, 2003; 108(7): 833 - 838. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Kearon Natural History of Venous Thromboembolism Circulation, June 17, 2003; 107(90231): I-22 - 30. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Ammann, M. Maggiorini, O. Bertel, E. Haenseler, H. I. Joller-Jemelka, E. Oechslin, E. I. Minder, H. Rickli, and T. Fehr Troponin as a risk factor for mortality in critically ill patients without acute coronary syndromes J. Am. Coll. Cardiol., June 4, 2003; 41(11): 2004 - 2009. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. P. Cannon and A. G.G. Turpie Unstable Angina and Non-ST-Elevation Myocardial Infarction: Initial Antithrombotic Therapy and Early Invasive Strategy Circulation, June 3, 2003; 107(21): 2640 - 2645. [Full Text] [PDF]
|
|
|
|
|
|
N. Kucher, N. Walpoth, K. Wustmann, M. Noveanu, and M. Gertsch QR in V1 - an ECG sign associated with right ventricular strain and adverse clinical outcome in pulmonary embolism Eur. Heart J., June 2, 2003; 24(12): 1113 - 1119. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Z. Goldhaber Cardiac Biomarkers in Pulmonary Embolism Chest, June 1, 2003; 123(6): 1782 - 1784. [Full Text] [PDF]
|
|
|
|
|
|
P. Pruszczyk, A. Bochowicz, A. Torbicki, M. Szulc, M. Kurzyna, A. Fijalkowska, and A. Kuch-Wocial Cardiac Troponin T Monitoring Identifies High-Risk Group of Normotensive Patients With Acute Pulmonary Embolism Chest, June 1, 2003; 123(6): 1947 - 1952. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 British Thoracic Society guidelines for the management of suspected acute pulmonary embolism Thorax, June 1, 2003; 58(6): 470 - 483. [Full Text] [PDF]
|
|
|
|
|
|
P. Pruszczyk, M. Szulc, G. Horszczaruk, H. Gurba, and M. Kobylecka Right Ventricular Infarction in a Patient With Acute Pulmonary Embolism and Normal Coronary Arteries Arch Intern Med, May 12, 2003; 163(9): 1110 - 1111. [Full Text] [PDF]
|
|
|
|
|
|
N. Kucher, G. Printzen, T. Doernhoefer, S. Windecker, B. Meier, and O. M. Hess Low Pro-Brain Natriuretic Peptide Levels Predict Benign Clinical Outcome in Acute Pulmonary Embolism Circulation, April 1, 2003; 107(12): 1576 - 1578. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Janata, M. Holzer, A. N Laggner, and M. Mullner Cardiac troponin T in the severity assessment of patients with pulmonary embolism: cohort study BMJ, February 8, 2003; 326(7384): 312 - 313. [Full Text] [PDF]
|
|
|
|
|
|
C. W. Hamm, E. Giannitsis, and H. A. Katus Cardiac Troponin Elevations in Patients Without Acute Coronary Syndrome Circulation, December 3, 2002; 106(23): 2871 - 2872. [Full Text] [PDF]
|
|
|
|
|
|
M. E. Bertrand, M. L. Simoons, K. A.A. Fox, L. C. Wallentin, C. W. Hamm, E. McFadden, P. J. De Feyter, G. Specchia, and W. Ruzyllo Management of acute coronary syndromes in patients presenting without persistent ST-segment elevation Eur. Heart J., December 1, 2002; 23(23): 1809 - 1840. [Full Text] [PDF]
|
|
|
|
|
|
P. Pruszczyk, M. Szulc, A. Torbicki, and K. E. Wood Cardiac Troponins in Acute Pulmonary Embolism Chest, December 1, 2002; 122(6): 2264 - 2265. [Full Text] [PDF]
|
|
|
|
|
|
S. Konstantinides, A. Geibel, M. Olschewski, W. Kasper, N. Hruska, S. Jackle, and L. Binder Importance of Cardiac Troponins I and T in Risk Stratification of Patients With Acute Pulmonary Embolism Circulation, September 3, 2002; 106(10): 1263 - 1268. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. S. Dieter, E. Ernst, D. J. Ende, and J. H. Stein Diagnostic Utility of Cardiac Troponin-I Levels in Patients with Suspected Pulmonary Embolism Angiology, September 1, 2002; 53(5): 583 - 585. [Abstract] [PDF]
|
|
|
|
 |
|
 S. Z. Goldhaber Echocardiography in the Management of Pulmonary Embolism Ann Intern Med, May 7, 2002; 136(9): 691 - 700. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Muller-Bardorff, B. Weidtmann, E. Giannitsis, V. Kurowski, and H. A. Katus Release Kinetics of Cardiac Troponin T in Survivors of Confirmed Severe Pulmonary Embolism Clin. Chem., April 1, 2002; 48(4): 673 - 675. [Full Text] [PDF]
|
|
|
|
 |
|
 I Weinberg, T Cukierman, and T Chajek-Shaul Troponin T elevation in lobar lung disease Postgrad. Med. J., April 1, 2002; 78(918): 244 - 245. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.Z. Goldhaber Modern treatment of pulmonary embolism Eur. Respir. J., February 1, 2002; 19(35_suppl): 22S - 27s. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. Douketis, M. A. Crowther, E. B. Stanton, and J. S. Ginsberg Elevated Cardiac Troponin Levels in Patients With Submassive Pulmonary Embolism Arch Intern Med, January 14, 2002; 162(1): 79 - 81. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Fitchett, S. Goodman, and A. Langer Troponin assays for coronary syndrome diagnosis Can. Med. Assoc. J., January 1, 2002; 166(1): 13 - 14. [Full Text] [PDF]
|
|
|
|
|
|
C-K Wong and H D White Recognising "painless" heart attacks Heart, January 1, 2002; 87(1): 3 - 5. [Full Text] [PDF]
|
|
|
|
|
|
M. J. Quinn and D. J. Moliterno Troponins in Acute Coronary Syndromes: More TACTICS for an Early Invasive Strategy JAMA, November 21, 2001; 286(19): 2461 - 2462. [Full Text] [PDF]
|
|
|
|
 |
|
 D. M. Sullivan, J. A. Watts, and J. A. Kline Biventricular cardiac dysfunction after acute massive pulmonary embolism in the rat J Appl Physiol, May 1, 2001; 90(5): 1648 - 1656. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Troponin T Is a Marker for Worse Prognosis in PE Journal Watch (General), July 25, 2000; 2000(725): 5 - 5. [Full Text]
|
|