Prognostic stratification of acute pulmonary embolism: Focus on clinical aspects, imaging, and biomarkers

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Authors: Luca Masotti, Marc Righini, Nicolas Vuilleumier, Fabio Antonelli, et al.

Published Date July 2009 Volume 2009:5 Pages 567 - 575

DOI: http://dx.doi.org/10.2147/VHRM.S4861

Luca Masotti¹, Marc Righini², Nicolas Vuilleumier³, Fabio Antonelli⁴, Giancarlo Landini⁵, Roberto Cappelli⁶, Patrick Ray⁷

¹Internal Medicine, ⁴Clinical Chemistry, Cecina Hospital, Cecina, Italy; ²Division of Angiology and Haemostasis, Department of Internal Medicine, Geneva University Hospital, Switzerland; ³Division of Laboratory Medicine, Department of Genetics and Laboratory Medicine, Geneva University Hospitals and University of Geneva, Switzerland; ⁵Internal Medicine, Santa Maria Nuova Hospital, Florence, Italy; ⁶Thrombosis Center, University of Siena, Siena, Italy; ⁷Department of Emergency Medicine, Centre Hospitalo-Universitaire Pitié-Salpêtrière, UPMC Paris 6, Paris, France

Abstract: Pulmonary embolism (PE) represents a common disease in emergency medicine and guidelines for diagnosis and treatment have had wide diffusion. However, PE morbidity and mortality remain high, especially when associated to hemodynamic instability or right ventricular dysfunction. Prognostic stratification to identify high risk patients needing to receive more aggressive pharmacological and closer monitoring is of utmost importance. Modern guidelines for management of acute PE are based on risk stratification using either clinical, radiological, or laboratory findings. This article reviews the modern treatment of acute PE, which is customized upon patient prognosis. Accordingly the current risk stratification tools described in the literature such as clinical scores, echocardiography, helical computer tomography, and biomarkers will be reviewed.

Keywords: pulmonary embolism, prognosis, troponin, BNP, NT-proBNP, echocardiography, computer tomography

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