Elevated cardiac biomarkers with normal right ventricular size indicate an unlikely diagnosis of acute pulmonary embolism in stable patients.

The purpose of this investigation is to assess the prevalence of elevated cardiac biomarkers, with or without estimates of right ventricular (RV) size, in stable patients with acute pulmonary embolism (PE). Our hypothesis is that the combination of high levels of cardiac troponin I (cTnI), high creatine kinase isoenzyme MB (CK-MB), and normal size RV are sufficiently uncommon in stable patients with PE to make the diagnosis of PE unlikely. Retrospective review showed a high cTnI plus high CK-MB in 20 (3.

Outcome in stable patients with acute pulmonary embolism who had right ventricular enlargement and/or elevated levels of troponin I.

Normotensive patients with acute pulmonary embolism (PE) who have increased troponin levels and right ventricular (RV) dysfunction are thought to be at high risk of death, but the level of risk is unclear. We retrospectively evaluated outcome in 1,273 stable patients with PE who had echocardiographic evaluations of RV size and/or measurement of cardiac troponin I (cTnI). In-hospital all-cause mortality was higher in those with RV enlargement (8.

Venous compression for prevention of postthrombotic syndrome: a meta-analysis.

Purpose: To determine the effectiveness of venous compression stockings or compression bandages on the reduction of postthrombotic syndrome in patients with deep venous thrombosis.

Methods: We attempted to identify all published trials in all languages identified by PubMed through June 2009. Meta-analysis was performed.

Outcomes with retrievable inferior vena cava filters.

This was a retrospective study of 144 patients with retrievable inferior vena cava (IVC) filters inserted between 2004 and 2008 at a community/teaching hospital. The purpose was to evaluate the incidence of complications and the rate and success of retrieval. Retrieval of IVC filters was attempted in 14 of 144 (10%) patients at an average of 4.

Resolution of pulmonary embolism on CT pulmonary angiography.

Objective: The objective of our study was to retrospectively determine the rate of resolution of pulmonary emboli (PEs) in individual vessels and the rate of complete resolution of PEs on CT angiography.

Materials And Methods: Follow-up CT pulmonary angiograms, obtained during the period from January 2006 through May 2009, of 69 patients with acute PE from two hospitals were assessed. Initial and follow-up CT angiograms were reread together by one radiologist at both of the hospitals.

Risk of venous thromboembolism with inflammatory bowel disease.

The purpose of this study is to determine the incidence of venous thromboembolism (VTE) in patients with ulcerative colitis and patients with Crohn disease. The number of patients discharged from hospitals throughout the United States with a diagnostic code for ulcerative colitis and for Crohn disease from 1979 through 2005 was obtained from the National Hospital Discharge Survey. The incidence of VTE among medical patients with ulcerative colitis was 21 000 of 1 129 000 (1.

SPECT in acute pulmonary embolism.

The purpose of this review was to evaluate the accuracy of SPECT in acute pulmonary embolism. Sparse data are available on the accuracy of SPECT based on an objective reference test. Several investigations were reported in which the reference standard for the diagnosis of pulmonary embolism was based in part on the results of SPECT or planar ventilation-perfusion (V/Q) imaging.

Early discharge of patients with venous thromboembolism: implications regarding therapy.

The purpose of this investigation is to show trends in the duration of hospitalization of patients with pulmonary embolism (PE) and deep venous thrombosis (DVT). The number of patients discharged from short-stay non-Federal hospitals throughout the United States with a primary diagnostic code for PE or DVT from 1979 through 2005 was obtained from the National Hospital Discharge Survey. By 2005, 13% of patients with PE were discharged in 1 to 2 days, 30% in 3 to 4 days, 26% in 5 to 6 days, and 31% in > or =7 days.

Anticoagulant therapy for acute venous thromboembolism: what we think we know and what the data show for the timing of recurrent events.

Although heparin is administered to prevent early recurrences of venous thromboembolism (VTE) by preventing new thrombi, allowing old thrombi to attach to venous walls, and covering warfarin until it is therapeutic, heparin largely prevents late recurrences of VTE (after 5 days). The dreaded early occurrence of pulmonary embolism (PE) (on or before day 5) while waiting for the vitamin K antagonist to become antithrombotic did not occur among patients with deep venous thrombosis (DVT), who received acencoumarol alone. Fewer total recurrences resulted if a therapeutic level of heparin was reached within the first 24 hours of treatment of DVT.

Incidence of thrombocytopenia in hospitalized patients with venous thromboembolism.

Purpose: To determine the incidence of heparin-associated thrombocytopenia in patients receiving prophylaxis or treatment for venous thromboembolism.

Methods: We assessed the database of the National Hospital Discharge Survey from 1979 through 2005 and complemented this with a meta-analysis of published literature.

Result: Among 10,554,000 patients discharged from short-stay hospitals throughout the US with venous thromboembolism during the 27 years of study, secondary thrombocytopenia was coded in 38,000 patients (0.

Venous thromboembolism in patients hospitalized with thyroid dysfunction.

The objective of this investigation is to explore a possible role of thyroid dysfunction in venous thromboembolism (VTE). The number of patients discharged from short-stay nonfederal hospitals in the United States, from 1979 to 2005, with a diagnostic code for hypothyroidism or hyperthyroidism, pulmonary embolism (PE), and deep venous thrombosis (DVT) was obtained from the National Hospital Discharge Survey (NHDS). Among 19,519,000 hospitalized patients discharged with a diagnosis of hypothyroidism from 1979 to 2005, 119,000 (0.

CT venous phase venography with 64-detector CT angiography in the diagnosis of acute pulmonary embolism.

The value of computed tomographic (CT) venography in combination with CT pulmonary angiography has been questioned because of the potential dangers of radiation. Accordingly, we retrospectively evaluated the diagnostic yield of 64-detector CT angiography with CT venography. Among patients who routinely underwent CT venography with CT angiography, the CT angiogram showed acute pulmonary embolism (PE) in 206 of 1903 patients (10.

Ankle exercise and venous blood velocity.

Ankle exercise increases venous blood velocity while supine, but the effect of ankle exercise on venous blood velocity while sitting is not known. In this investigation, we test the hypothesis that venous blood velocity can be increased while sitting by repetitive dorsiflexion of the foot. Time-averaged peak velocity (TAPV) in the popliteal vein of 20 healthy male volunteers was measured by pulsed Doppler ultrasound at rest and during ankle exercise in the supine and sitting positions.

Diabetes mellitus and risk of venous thromboembolism.

Background: : To determine if diabetes mellitus is a risk factor for venous thromboembolism (VTE).

Research Design And Methods: : Data from the National Hospital Discharge Survey were analyzed from 1979 to 2005. International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify diseases.

Reconstructed 4-chamber views compared with axial imaging for assessment of right ventricular enlargement on CT pulmonary angiograms.

Purpose: To test the hypothesis that right enlargement assessed from right ventricular/left ventricular (RV/LV) dimension ratios of computed tomographic (CT) angiograms are equivalent irrespective of whether measured on axial views or reconstructed 4-chamber views.

Methods: RV/LV dimension ratios were calculated from measurements on axial views, manually reconstructed 4-chamber views and computer generated reconstructed 4-chamber views of CT angiograms in 152 patients with PE.

Results: Paired readings of the axial view and manually reconstructed 4-chamber view showed agreement with RV/LV > or =1 or RV/LV <1 in 114 of 127 (89.

Incidence of amniotic fluid embolism: relation to cesarean section and to age.

Aims: To determine the incidence of amniotic fluid embolism and the incidence as modified by cesarean section and age.

Methods: Data are from the National Hospital Discharge Survey. We examined the number of patients discharged from short-stay nonfederal hospitals throughout the United States, from 1980 through 2005, with a diagnostic code for amniotic fluid embolism.

Risk of venous thromboembolism with rheumatoid arthritis.

Rheumatoid arthritis is not generally considered to be a risk factor for venous thromboembolism (VTE), although abnormalities of coagulation factors have been found in patients with rheumatoid arthritis. Sparse data in a few patients suggest that patients with rheumatoid arthritis may have higher rates of VTE. The purpose of this investigation was to determine if the incidences of pulmonary embolism (PE) and deep venous thrombosis (DVT) are increased in hospitalized patients with rheumatoid arthritis.

Fat embolism syndrome.

Objectives: To assess the incidence and risk factors for fat embolism syndrome.

Materials And Methods: Data from the National Hospital Discharge Survey (NHDS) were analyzed using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes.

Results: From 1979 through 2005 among 928,324,000 patients discharged from short-stay hospitals in the United States, 41,000 (0.

Human immunodeficiency virus infection and risk of venous thromboembolism.

Background: The incidence of venous thromboembolism (VTE) in HIV-infected patients is uncertain, and the impact of protease inhibitors on the incidence of VTE is also uncertain, yet important to know to create a database for providing opinion regarding prophylaxis for the prevention of VTE.

Methods: Data from the National Hospital Discharge Survey (NHDS) were analyzed from 1990 through 2005. International Classification of Diseases, Ninth Revision, and Clinical Modification (ICD-9-CM) codes were used to identify illnesses.

Treatment of acute pulmonary embolism as outpatients or following early discharge. A systematic review.

The purpose of this systematic review is to test the hypothesis that carefully selected low-risk patients with acute pulmonary embolism (PE) can safely be treated entirely as outpatients or after early hospital discharge. Included articles were required to describe inclusion or exclusion criteria and outcome of patients treated for PE. Early hospital discharge was defined as an average hospital stay < or = 3 days.

Incidence of vena cava thrombosis in the United States.

From 1979 through 2005, vena cava thrombosis (either superior or inferior) was diagnosed in 99,000 hospitalized patients. Most, 78%, had isolated vena cava thrombosis. From 2000 to 2005, 5,000 patients were diagnosed yearly with vena cava thrombosis (1.

64-slice CT for diagnosis of coronary artery disease: a systematic review.

Purpose: The purpose of this systematic review was to assess the accuracy of 64-slice CT coronary angiography for the diagnosis of coronary artery disease.

Methods: We attempted to identify all published trials in all languages that used 64-slice CT to diagnose coronary artery disease. Results of 64-slice CT coronary angiography were compared with invasive coronary angiography or intravascular ultrasound.