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The prognostic relevance of H-FABP levels and other baseline parameters with regard to 30-day outcome was estimated with logistic regression analysis with the calculated or prospectively defined cutoff values. The results are presented as odds ratios (ORs) with the corresponding 95% confidence intervals (CIs). To identify predictors of long-term GDC 0199 mortality, Cox proportional hazards regression analysis was performed with Wald's test; these results are presented as hazard ratios with corresponding 95% CIs. Survival rates were estimated by the Kaplan-Meier method, and statistical comparison was performed with the log-rank test. All tests were 2-sided and used a significance level of 0.05. The ROC curves from different biomarkers were compared with the software Analyse-it (version 2.21 Excel 12+, Analyse-it Software, Ltd., Leeds, United Kingdom), which applies the method of DeLong et al. (24). All other analyses were performed with the SPSS 17.0 software (SPSS, Inc., Chicago, Illinois) and GraphPad Prism 4 (GraphPad Software, San Diego, California). The baseline clinical characteristics and biomarker levels of the study population are summarized in Table 1. The H-FABP concentrations on admission ranged from 0.39 to 217.5 ng/ml with a median value of 3.4 ng/ml (interquartile range [IQR] 2.2 to 5.4 ng/ml). During the first 30 days, 9 (7%) patients suffered major complications: 6 patients died, 5 underwent cardiopulmonary resuscitation, and 7 required catecholamines and/or endotracheal intubation. Patients who developed complications had elevated H-FABP values on admission (median, 11.2 ng/ml; IQR 8.0 to 36.8 ng/ml) compared with patients with an uncomplicated course Raf inhibitor review (3.4 [IQR 2.1 to 4.9] ng/ml; p < 0.001). In contrast, neither the baseline cTnT Torin 1 concentrations nor those of NT-proBNP differed significantly between patients suffering complications within 30 days and those with an uncomplicated course (cTnT, 0.12 [0.009 to 0.26] ng/ml vs. 0.009 [0.009 to 0.04] ng/ml; p = 0.072; NT-proBNP, 1,914 [IQR 525 to 25,462] pg/ml vs. 980 [IQR 181 to 2,630] pg/ml; p = 0.10). Receiver operating characteristic analysis further suggested that H-FABP levels on admission are a powerful predictor of 30-day outcome in normotensive patients with acute PE (Fig. 1). The calculated AUC was 0.89 (95% CI: 0.77 to 1.01) for H-FABP, 0.68 (95% CI: 0.47 to 0.9) for cTnT, and 0.67 (95% CI: 0.48 to 0.85) for NT-proBNP. The AUC for H-FABP was significantly higher than the AUC for NT-proBNP (p = 0.017), in a comparison of all 3 AUCs (24); other p values were p = 0.085 for H-FABP/cTnT and p = 0.834 for cTnT/NT-proBNP). With ROC analysis, a concentration of 6.09 ng/ml was identified as the best cutoff level for H-FABP in our study population. Notably, this is almost identical to the cutoff value of 6 ng/ml found in previous studies that tested H-FABP in unselected patients with acute PE (15) and in patients with acute coronary syndromes (25?and?26).
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