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    Diagnostic Value of Galectin-3 for Identifying Acute Pulmonary Embolism in the Emergency Department
    (Elsevier Inc., 2022) Kara, Hasan; Bayir, Aysegul; Altug, Ertugrul; Degirmenci, Selim; Unlu, Ali; Ak, Ahmet; Kayis, Seyit Ali
    Background: Pulmonary embolism (PE) is a common disease associated with high mortality and morbidity. Diagnosing PE is challenging due to diverse clinical presentations and the lack of specific biomarkers. Objective: We hypothesized that plasma galectin-3 (Gal-3) levels might reflect the severity of acute PE and be useful for diagnostic assessment. Methods: In this prospective study, 150 patients (100 patients with PE and 50 control patients) were included. Patients were stratified into high-risk, medium-risk, and low-risk groups according to the Wells and revised Geneva scoring systems, and Gal-3 levels were compared among the groups. PE was diagnosed by means of computed tomography pulmonary angiography. Results: In this study, of the 100 PE patients included in the study, 69 patients recovered and were discharged and 31 patients died. Median Gal-3 value in the PE group was 27.0 ng/mL (range 11.5–35.0 ng/mL), whereas the median Gal-3 value in the control group was significantly lower at 8.8 ng/mL (range 1.0–21.0 ng/mL) (p < 0.001). When the Gal-3 values of the PE group and the control group were evaluated with the receiver operator characteristic curve, the area under the curve was calculated as 0.99 (95% confidence interval 0.979–1). At a Gal-3 cutoff value of 13.55 ng/mL, which was determined to be the most appropriate value for PE diagnosis, the sensitivity was 98% and the specificity was 92%. Conclusions: A biomarker that rapidly and accurately diagnoses acute PE in the emergency department can be an extremely useful tool. We concluded that plasma Gal-3 levels can be regarded as a promising marker of acute PE. © 2022
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    Diagnostic value of mid-regional pro-atrial natriuretic peptide (MR-proANP) level in patients with acute pulmonary embolism
    (Bayrakol Medical Publisher, 2023) Altuğ, Ertuğrul; Kara, Hasan; Bayır, Ayşegül; Ak, Ahmet; Kayış, Seyit Ali; Ünlü, Ali
    Aim: Right ventricular failure can develop in patients with pulmonary embolism (PE) and is associated with increased mortality. Mid-regional pro-atrial natriuretic peptide (MR-proANP), a natriuretic peptide, is secreted due to the increased atrial wall tension caused by right heart failure. In this study, we aimed to investigate the diagnostic value of MR-proANP in patients who presented to the emergency department with a pre-diagnosis of pulmonary embolism.Material and Methods: Among patients with a preliminary diagnosis of PE, 100 patients who were confirmed to have PE by computed tomography pulmonary angiography (CTPA) were determined as the case group. As a control group, 50 patients were randomly identified, in whom the diagnosis of PE was excluded. Echocardiography was performed in all patients in the case group immediately after the diagnosis was confirmed, and the presence of right ventricular dysfunction was investigated. This study was designed as a prospective observational study.Results: The median value of MR-proANP (645.8 (66.37-3313.08) pmol/L) in the case group was found to be significantly higher than median value of MR-proANP (442.9 (226.73-774.78) pmol/L) in the control group (p:0.003). MR-proANP was found to be significantly higher in the differential diagnosis of PE.Discussion: In addition to clinical signs and symptoms, MR-proANP levels seem to be a useful variable that may improve diagnostic accuracy in patients with suspected pulmonary embolism in the emergency department.