• Karsten Keller, Johannes Beule, Meike Coldewey, Martin Geyer, Jörn Oliver Balzer, and Wolfgang Dippold.
• Department of Medicine II, University Medical Center Mainz, Johannes Gutenberg-University Mainz, Germany; Centrum for Thrombosis and Haemostasis, University Medical Center Mainz, Johannes Gutenberg-University Mainz, Germany. Electronic address: Karsten.Keller@unimedizin-mainz.de.
• Exp. Gerontol. 2015 Sep 1; 69: 116-21.

IntroductionRight ventricular dysfunction (RVD), submassive pulmonary embolism (PE), elevated systolic pulmonary artery pressure (sPAP), elevated cardiac troponin I (cTnI) and old age are well-known risk factors for poor outcome in acute normotensive PE. The aim of this analysis was to calculate age cut-off values to predict submassive PE, cardiac injury, RVD and elevated sPAP in normotensive PE patients.MethodsRetrospective analysis of clinical, laboratory, radiological and echocardiographic data of normotensive PE patients (2006-2011) was performed. Receiver operating characteristic (ROC) curves and Youden indexes were used to test the effectiveness of using patients' ages at the PE event to predict a submassive PE, cardiac injury (elevated cTnI >0.1ng/ml), RVD and elevated sPAP (>30mmHg) in normotensive PE patients and to calculate optimal cut-off values. Patients >76years were compared to those aged ≤76years.Results129 normotensive PE patients (59.7% women) met the inclusion criteria and were included in this analysis. The optimal cut-off value for patient ages to predict submassive PE, cardiac injury (elevated cTnI >0.1ng/ml), RVD and elevated sPAP (>30mmHg) was 76.5, 81.5, 66.5 and 66.5years, respectively, with moderate effectiveness (AUC 0.69, 0.58, 0.71 and 0.69, respectively). Patients >76years old had higher percentages of submassive PE (91.1% vs. 63.1%, P=0.000680), RVD (91.1% vs. 58.3%, P=0.000119), sPAP (42.64±16.70 vs. 29.24±17.56mmHg, P=0.000044) and cTnI (0.22±0.40 vs. 0.10±0.25ng/ml, P=0.00488).ConclusionsAge is an important prognostic factor in acute normotensive PE. In addition to cTn and RVD, age should be taken into account in determining the risk stratification for acute PE.Copyright © 2015 Elsevier Inc. All rights reserved.

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