2Department of Biochemistry Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
3Department of Biochemistry Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
4Department of Emergency Medicine, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
5Department of Public Health Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
6Department of Radiology Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
7Department of Chest Diseases Faculty of Medicine, Karadeniz Teknik University, Trabzon-Turkey
8Department of Emergency Medicine, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
Abstract
Objective: To investigate possible relationship between the D-dimer and ischemia-modified albumin (IMA) levels and radiological imaging-based severity scores in pulmonary embolism (PE) based on two different radiological characteristics; the pulmonary arterial obstruction index (PAOI) and the right ventricle/left ventricle (RV/LV) ratio. Methods: In this prospective cohort study, forty-seven patients presenting to the emergency department and definitively diagnosed with PE using spiral computerized tomography (CT) were initially enrolled in the study. Levels of IMA and D-dimer were assessed colorimetrical and immuno-turbidimetric methods, respectively. The PAOI and RV/LV ratios were calculated from CT images. The levels of biochemical parameters between the groups were compared with use of Mann-Whitney U and Kruskal-Wallis tests and relationship between the radiological scores were assessed using the Spearman correlation test. Results: Analysis of the calculated PAOI and RV/LV ratio revealed a significant correlation between them (r=0.36, p=0.023). D-dimer levels differed considerably among the mild (<40%), moderate (40%-60%) and severe (60%) groups constituted on the basis of PAOI (p=0.039). This difference stemmed from those in D-dimer levels in the mild group, PAOI <40 % and the severe group, PAOI 60% (p=0.02; Z= -2.328). In addition, D-dimer levels and PAOI revealed a positive correlation, but no similar correlation was determined between D-dimer levels and RV/LV. There were no significant correlations between IMA and D-dimer levels, PAOI and RV/LV ratios. Conclusion: In the biochemical determination of severity of PE based on radiological characteristics, D-dimer may be a more relevant marker than IMA, which has been proposed as a new marker.