PMID- 36793097
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230218
IS  - 1477-9560 (Print)
IS  - 1477-9560 (Electronic)
IS  - 1477-9560 (Linking)
VI  - 21
IP  - 1
DP  - 2023 Feb 15
TI  - Additive prognostic value of serum calcium to the ESC risk stratification in 
      patients with acute pulmonary embolism.
PG  - 20
LID - 10.1186/s12959-023-00461-y [doi]
LID - 20
AB  - BACKGROUND: Hypocalcemia has been shown to be involved in the adverse outcomes of 
      acute pulmonary embolism (APE). We aimed to determine the incremental value of 
      adding hypocalcemia, defined as serum calcium level </= 2.12 mmol/L, on top of the 
      European Society of Cardiology (ESC) prognostic algorithm, for the prediction of 
      in-hospital mortality in APE patients, which in turn could lead to the 
      optimization of APE management. METHODS: This study was conducted at West China 
      Hospital of Sichuan University from January 2016 to December 2019. Patients with 
      APE were retrospectively analyzed and divided into 2 groups based on serum 
      calcium levels. Associations between hypocalcemia and adverse outcomes were 
      assessed by Cox analysis. The accuracy of risk stratification for in-hospital 
      mortality was assessed with the addition of serum calcium to the current ESC 
      prognostic algorithm. RESULTS: Among 803 patients diagnosed with APE, 338 (42.1%) 
      patients had serum calcium levels </= 2.12 mmol/L. Hypocalcemia was significantly 
      associated with higher in-hospital and 2-year all-cause mortality compared to the 
      control group. The addition of serum calcium to ESC risk stratification enhanced 
      net reclassification improvement. Low-risk group with serum calcium 
      level > 2.12 mmol/L had a 0% mortality rate, improving the negative predictive 
      value up to 100%, while high-risk group with serum calcium level </= 2.12 mmol/L 
      indicated a higher mortality of 25%. CONCLUSION: Our study identified serum 
      calcium as a novel predictor of mortality in patients with APE. In the future, 
      serum calcium may be added to the commonly used ESC prognostic algorithm for 
      better risk stratification of patients suffering from APE.
CI  - (c) 2023. The Author(s).
FAU - Zhang, Jiarui
AU  - Zhang J
AD  - Department of Respiratory and Critical Care Medicine, West China Hospital of 
      Sichuan University, Chengdu, Sichuan, China.
FAU - Ali, Adila
AU  - Ali A
AD  - Department of Respiratory and Critical Care Medicine, West China Hospital of 
      Sichuan University, Chengdu, Sichuan, China.
FAU - Liu, Yu
AU  - Liu Y
AD  - Department of Respiratory and Critical Care Medicine, West China Hospital of 
      Sichuan University, Chengdu, Sichuan, China.
FAU - Peng, Lige
AU  - Peng L
AD  - Department of Respiratory and Critical Care Medicine, West China Hospital of 
      Sichuan University, Chengdu, Sichuan, China.
FAU - Pu, Jiaqi
AU  - Pu J
AD  - Department of Respiratory and Critical Care Medicine, West China Hospital of 
      Sichuan University, Chengdu, Sichuan, China.
FAU - Yi, Qun
AU  - Yi Q
AD  - Department of Respiratory and Critical Care Medicine, West China Hospital of 
      Sichuan University, Chengdu, Sichuan, China. yiqun925@126.com.
AD  - Cancer Hospital Affiliate to School of Medicine, Sichuan Cancer Hospital and 
      Institution, Sichuan Cancer Center, UESTC, Sichuan Province, Chengdu, China. 
      yiqun925@126.com.
FAU - Zhou, Haixia
AU  - Zhou H
AD  - Department of Respiratory and Critical Care Medicine, West China Hospital of 
      Sichuan University, Chengdu, Sichuan, China. zhouhaixia@wchscu.cn.
LA  - eng
PT  - Journal Article
DEP - 20230215
PL  - England
TA  - Thromb J
JT  - Thrombosis journal
JID - 101170542
PMC - PMC9930215
OTO - NOTNLM
OT  - Acute pulmonary embolism
OT  - ESC prognostic algorithm
OT  - Risk stratification
OT  - Serum calcium
COIS- The authors declare that they have no competing interests.
EDAT- 2023/02/17 06:00
MHDA- 2023/02/17 06:01
PMCR- 2023/02/15
CRDT- 2023/02/16 00:39
PHST- 2022/09/19 00:00 [received]
PHST- 2023/01/30 00:00 [accepted]
PHST- 2023/02/16 00:39 [entrez]
PHST- 2023/02/17 06:00 [pubmed]
PHST- 2023/02/17 06:01 [medline]
PHST- 2023/02/15 00:00 [pmc-release]
AID - 10.1186/s12959-023-00461-y [pii]
AID - 461 [pii]
AID - 10.1186/s12959-023-00461-y [doi]
PST - epublish
SO  - Thromb J. 2023 Feb 15;21(1):20. doi: 10.1186/s12959-023-00461-y.