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The Association of Serum Lactate Dehydrogenase Levels with In- Hospital Mortality due to Pulmonary Embolism


avatar Samad Ghaffari ORCID 1 , avatar Reza Hajizadeh ORCID 2 , avatar Tooba Mohammadi ORCID 3 , avatar Hadiseh Kavandi ORCID 1 , avatar Kamran Mohammadi ORCID 1 , avatar Mehdi Mohebbalizadeh ORCID 3 , avatar Sahar Ghodratizadeh ORCID 4 , avatar Amin Sedokani ORCID 2 , 3 , *

1 Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran

2 Department of Cardiology, Urmia University of Medical Sciences, Urmia, IR Iran

3 Student Research Committee, Urmia University of Medical Sciences, Urmia, IR Iran

4 Department of Anesthesiology, Urmia University of Medical Sciences, Urmia, IR Iran

How to Cite: Ghaffari S, Hajizadeh R, Mohammadi T, Kavandi H, Mohammadi K, et al. The Association of Serum Lactate Dehydrogenase Levels with In- Hospital Mortality due to Pulmonary Embolism. Int Cardio Res J. 2022;16(3):e121597.


International Cardiovascular Research Journal: 16 (3); e121597
Published Online: September 30, 2022
Article Type: Research Article
Received: November 30, 2021
Revised: August 27, 2022
Accepted: September 10, 2022


Background: A significant correlation exists between elevated lactate dehydrogenase
(LDH) levels and thrombotic events, yet the prognostic value of this biomarker in
patients with pulmonary embolism (PE) remains elusive. Finding new biomarkers can
help us achieve better risk stratification and treatment strategies to reduce the mortality
of PE patients.
Objectives: We aimed to determine the possible association between serum LDH and
the in-hospital mortality of PE patients.
Methods: In this cross-sectional study, 217 patients with PE (diagnosed by computed
tomography angiography) and a serum LDH level documented within the first 24 hours
of admission were included. Our exclusion criteria were hepatic and renal diseases,
pregnancy, hemolytic disorders, left ventricular infarction, recent stroke, positive history
of active cancer, acute and chronic infections, and reticuloendothelial-related diseases.
Results: The mean age of patients was 63.04 ± 16.81 years; 23 patients (10.6%) died
during hospitalization. Multivariate analysis showed that LDH and white blood cells
(WBC) were independent predictors of in-hospital mortality; however, this association
was insignificant. Univariate analysis showed that higher levels of LDH, WBC, and red
cell distribution width (RDW) had a significant association with in-hospital mortality
(P < 0.05). The receiver operating characteristics curve showed that an LDH cut-off value
of 515 U/l had a sensitivity of 91.3% and specificity of 45.9% in predicting in-hospital
mortality (95% CI = 0.636 – 0.761, P = 0.0003).
Conclusion: LDH can be an excellent prognostic marker for predicting in-hospital death
in patients with pulmonary embolism.


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