Abstract Objective To evaluate the prognostic value of high sensitive cardiac troponin I(hs-cTnI)combined with global acute coronary events(GRACE)score in patients with acute pulmonary embolism(APE). Methods A total of 182 APE patients were selected from January 2013 to September 2016 in our hospital. According to the 30 days all-cause mortality they were divided into death group(n=40)and survival group(n=142). According to the GRACE score of acute coronary syndrome patients were divided into low risk group(n=38), middle risk group(n=61)and high risk group(n=83). According to the hs-cTnI results the patients were divided into high hs-cTnI group(hs-cTnI>0.01 ng/mL)with 115 cases and low hs-cTnI group(hs-cTnI ≤0.01 ng/mL)with 67 cases. The levels of hs-cTnI, GRACE score and the incidence of adverse events were compared between the two groups. Univariate and multivariate logistic regression were used to analyze the risk factors of death in patients with APE. Mapping ROC curve was used to evaluate the prognostic value of hs-cTnI and GRACE score in patients with APE. Results The mortality rate of 30 days, hemoptysis and respiratory failure in high hs-cTnI group was significantly higher than that in low hs-cTnI group(P<0.05). The incidence rate of 30 days mortality, hemoptysis and respiratory failure in the high risk group was significantly higher than that in the low risk group(P<0.05). Multivariate 了ogistic regression analysis showed that high hs-cTnI and high GRACE score were independent risk factors for death in patients with APE, and the OR and 95%CI were 1.708(1.259~2.336)and 2.461(1.853~3.286), respectively. The ROC curve showed that the hs-cTnI, GRACE score and the combination of the two predicted 30 days mortality in patients with APE of AUC and 95%CI were 0.767(0.683~0.856), 0.785(0.692~0.884), 0.853(0.761~0.942), and the sensitivity and specificity of the two joint examination for predicting the mortality of patients with APE in the 30 days were the best. Correlation analysis showed that GRACE score was positively correlated with hs-cTnI level(r=0.682, P<0.01). Conclusion Hs-cTnI and GRACE score are independent risk factors for death in patients with APE, and the combination of the two indexes is of better value in the prognosis of patients with APE.
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