Turk Kardiyol Dern Ars. Ahead of Print: TKDA-78241 | DOI: 10.5543/tkda.2018.78241
Prediction of New Onset Atrial Fibrillation in Patients with Acute Pulmonary Embolism; The Role of sPESI Score
, Suzan Şahan2
, Murat Karamanlıoğlu1
, Murat Gül3
, Omaç Tüfekçioğlu21
Atatürk Chest Disease and Thorasic Surgery Training and Research Hospital, Cardiology, Ankara Turkey2
Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology, Ankara, Turkey3
Düzce State Hospital, Cardiology, Düzce, Turkey
OBJECTIVE Acute pulmonary embolism (APE) and atrial fibrillation(AF) are two potentially fatal entities that frequently co-exist and complicate the outcome of each other.The pulmonary embolism severity index(PESI) is the acceptedrisk stratification toolto predict short term mortality in APE. The aim ofthis study was to evaluatethe relation between PESI score and new onset AF in patients with APE.
METHODS Records of 869 APE patients admitted between May 2012 and December 2015 were evaluated for new onset AF (defined as onset of AF within ??)PESI score was calculated for every patient. Clinical variables associated with new onset AF in APE were assessed after exclusion of the patients with hypertension, coronary or hemodynamically significant valvularheart disease, hepatic or renal dysfunction, chronic obstructive pulmonary disease, thyroid dysfunction, di±abetes mellitus or sleep apnea,any history of inflammatory or infection disease or recent trauma.,
RESULTS New onset AF was detected in 42 (4.8%) patients. Age, gender, systolic and diastolic blood pressure, heart rate, fasting glucose, and serum creatinin, LV ejection fraction, TAPSE and pulmonary artery systolic pressure were not different between patients with and without AF. New-AF patients showed larger left ventricular enddiastolic and left atrial dimensions, higher troponin, alkalen phosphatase and bilirubin and lower albumin levels..PESI scores were higher in new onset-AF group (93±23 vs.75+17; P<0.001).LVEDD,LAD,uric acid,bilirubine,albumin troponin levels and PESI scores were univariate predictors of New-AF.
DISCUSSION In patients with APE, PESI scores were positively correlated with new-AF. A PESI score higher than 82,50 may be useful to predict new-onset AF in these patients.
acute pulmonary embolism, atrial fibrillation, pulmonary emboli severity index, SPESI score
How to cite this article
Corresponding Author: Ekrem Şahan, Türkiye