Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
ORIGINAL ARTICLES
Association of Admission Glucose Level and Improvement in Pulmonary Artery Pressure in Patients with Submassive-type Acute Pulmonary Embolism
Masaomi GohbaraKeigo HayakawaAzusa HayakawaYusuke AkazawaYukihiro YamaguchiShuta FurihataAi KondoYusuke FukushimaSakie TomariTakayuki MitsuhashiTsutomu EndoKazuo Kimura
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JOURNAL OPEN ACCESS

2018 Volume 57 Issue 5 Pages 647-654

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Abstract

Objective The admission glucose level is a predictor of mortality even in patients with acute pulmonary embolism (APE). However, whether or not the admission glucose level is associated with the severity of APE itself or the underlying disease of APE is unclear.

Methods This study was a retrospective observational study. A pulmonary artery (PA) catheter was used to accurately evaluate the severity of APE. The percentage changes in the mean PA pressure (PAPm) upon placement and removal of the inferior vena cava filter (IVCF) were evaluated. We hypothesized that the admission glucose level was associated with the improvement in the PA pressure in patients with APE.

Patients A total of consecutive 22 patients with submassive APE who underwent temporary or retrievable IVCF insertion on admission and repetitive PA catheter measurements upon placement and removal of IVCFs were enrolled.

Results There was a significant positive correlation between the admission glucose levels and the percentage changes in the PAPm (r=0.543, p=0.009). A univariate linear regression analysis showed that the admission glucose level was the predictor of the percentage change in PAPm (β coefficient=0.169 per 1 mg/dL; 95% confidence interval, 0.047-0.291; p=0.009). A multivariate linear regression analysis with the forced inclusion model showed that the admission glucose level was the predictor of the percentage change in PAPm independent of diabetes mellitus, PAPm on admission, troponin positivity, and brain natriuretic peptide level (all p<0.05).

Conclusion The admission glucose level was associated with the improvement in the PAPm in patients with submassive-type APE.

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© 2018 by The Japanese Society of Internal Medicine
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