{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T16:09:34Z","timestamp":1777478974291,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Appl Thromb Hemost"],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:p>Among patients with pulmonary embolism (PE), various permutations of normal or abnormal cardiac troponin results and normal or abnormal echocardiographic right ventricular function are encountered in clinical practice. We aimed to explore whether there is a true gradient of risk based on troponin and echocardiographic results. This study included normotensive patients with PE from the PROgnosTic valuE of CT scan in hemodynamically stable patients with acute symptomatic pulmonary embolism (PROTECT) study. Patients were categorized as having -Troponin\/-Echo, -Troponin\/+Echo, +Troponin\/-Echo, and +Troponin\/+Echo. The primary outcome was 30-day \u201ccomplicated course,\u201d including death from any cause, hemodynamic collapse, or recurrent PE. Secondary outcomes included individual adverse event rates. Of the 834 patients who had echocardiographic and troponin results, 569 patients (68%) had -Troponin\/-Echo, 126 patients (15%) had -Troponin\/+Echo, 74 patients (8.9%) had +Troponin\/-Echo, and 65 patients (7.8%) had +Troponin\/+Echo. The incidence of 30-day complicated course was 4.6% in patients with -Troponin\/-Echo, 11.9% in patients with -Troponin\/+Echo, 13.5% in patients with +Troponin\/-Echo, and 16.9% in patients with +Troponin\/+Echo (P for trend &lt;0.001). In the subgroup of patients with a high-risk sPESI (i.e., intermediate-risk according to the ESC guidelines) (n = 527), the incidence of 30-day complicated course was 14.9% in patients with -Troponin\/+Echo, 18.5% in patients with +Troponin\/-Echo, and 17.5% in patients with +Troponin\/+Echo (P for trend &lt;0.01). In patiens with PE, there seems to be a risk gradient based on troponin and echocardiographic results. This study did not detect a significant risk difference in those with +Troponin\/-Echo compared with -Troponin\/+Echo.<\/jats:p>","DOI":"10.1177\/1076029620967760","type":"journal-article","created":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T15:49:05Z","timestamp":1607960945000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Implications of Abnormal Troponin Levels With Normal Right Ventricular Function in Normotensive Patients With Acute Pulmonary Embolism"],"prefix":"10.1177","volume":"26","author":[{"given":"Rosa","family":"Mirambeaux","sequence":"first","affiliation":[{"name":"Respiratory Department, Ram\u00f3n y Cajal Hospital and Alcala de Henares University, IRYCIS, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raphael","family":"Le Mao","sequence":"additional","affiliation":[{"name":"Groupe d\u2019Etude de la Thrombose de Bretagne Occidentale (GETBO), Universit\u00e9 Europ\u00e9enne de Bretagne, Brest, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfonso","family":"Muriel","sequence":"additional","affiliation":[{"name":"Biostatistics Department, Ram\u00f3n y Cajal Hospital and Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria IRYCIS, CIBERESP, Madrid, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"Pintado","sequence":"additional","affiliation":[{"name":"Respiratory Department, Ram\u00f3n y Cajal Hospital and Alcala de Henares University, IRYCIS, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"P\u00e9rez","sequence":"additional","affiliation":[{"name":"Respiratory Department, Ram\u00f3n y Cajal Hospital and Alcala de Henares University, IRYCIS, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6238-7042","authenticated-orcid":false,"given":"Diurbis","family":"Velasco","sequence":"additional","affiliation":[{"name":"Respiratory Department, Ram\u00f3n y Cajal Hospital and Alcala de Henares University, IRYCIS, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Luis","family":"Lobo","sequence":"additional","affiliation":[{"name":"CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain"},{"name":"Respiratory Department, Hospital Araba, Vitoria, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deisy","family":"Barrios","sequence":"additional","affiliation":[{"name":"Respiratory Department, Ram\u00f3n y Cajal Hospital and Alcala de Henares University, IRYCIS, Madrid, Spain"},{"name":"CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raquel","family":"Morillo","sequence":"additional","affiliation":[{"name":"Respiratory Department, Ram\u00f3n y Cajal Hospital and Alcala de Henares University, IRYCIS, Madrid, Spain"},{"name":"CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Behnood","family":"Bikdeli","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York-Presbyterian Hospital, NY, USA"},{"name":"Center for Outcomes Research and Evaluation (CORE), Yale University School of Medicine, New Haven, USA"},{"name":"Cardiovascular Research Foundation, NY, 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Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,12,14]]},"reference":[{"key":"bibr1-1076029620967760","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz405"},{"key":"bibr2-1076029620967760","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2018.11.009"},{"key":"bibr3-1076029620967760","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2015.11.026"},{"key":"bibr4-1076029620967760","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000707"},{"key":"bibr5-1076029620967760","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1564733"},{"key":"bibr6-1076029620967760","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200506-862OC"},{"key":"bibr7-1076029620967760","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2010.199"},{"key":"bibr8-1076029620967760","doi-asserted-by":"publisher","DOI":"10.1111\/jth.12146"},{"key":"bibr9-1076029620967760","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.552216"},{"key":"bibr10-1076029620967760","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2005.03.062"},{"key":"bibr11-1076029620967760","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-012-0709-7"},{"key":"bibr12-1076029620967760","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2012-202900"},{"key":"bibr13-1076029620967760","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201311-2040OC"},{"key":"bibr14-1076029620967760","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.185.2.1410342"},{"key":"bibr15-1076029620967760","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.101.24.2817"},{"key":"bibr16-1076029620967760","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00113307"},{"key":"bibr17-1076029620967760","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2017.09.007"},{"key":"bibr18-1076029620967760","doi-asserted-by":"publisher","DOI":"10.1160\/TH15-09-0761"},{"key":"bibr19-1076029620967760","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00024-2016"},{"key":"bibr20-1076029620967760","doi-asserted-by":"publisher","DOI":"10.1378\/chest.121.3.877"},{"issue":"6","key":"bibr21-1076029620967760","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/j.recesp.2014.10.018","volume":"68","author":"Bardaj\u00ed 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