The value of the angiotensin converting enzyme levels in determining the diagnosis of the acute pulmonary embolism

tudy Objective: Pulmonary embolism (PE) is a still on going disease with high ratesof morbidity and mortality because of delays in the diagnosis and treatment, despiteprogresses in the diagnostic tools. Angiotensin Converting Enzyme (ACE) is a dipeptidasewhich is produced in the pulmonary vasculature and found at the different levels in thedifferent pulmonary diseases. In our study, we investigated ACE level if it determines thediagnosis and management of PE and also if it predicts the prognosis of the disease in thepatients who present to the emergency department (ED).Methods: Patients were grouped into two groups as PE (+) group and PE (-) groupaccording to algorithm in the study. A control group of 16 healthy volunteers were alsoformed. The blood samples were taken from both groups and control group and ACE levelswere studied and analyzed.Results: We had 67 patients at the study (34 women, %68). 28/67 patients (%42) werein PE (+) group. There was no statistically difference between P (+) and P (-) groups in meansof ACE levels (p=0.894). In both PE (+) and PE (-) groups, ACE levels were significantlyhigher according to ACE levels of control group (respectively, p=0.040 and p=0.017). In PE(+) group, 19/28 were women and 9/28 were men and the differences between the genderswere statistically significant (68% women vs 32% men, p=0.034). There were no differencesin ACE levels between both P (+) and P (-) groups according to the gender (p=0.306). TheACE levels of women in PE (+) group, were significantly lower than ACE levels of men inPE (+) group (p=0.046). There were no differences in ACE levels of patients in PE (+) groupwhich fibrinolytic therapy had been given or not (p=0.834). There were no differencesbetween ACE levels of patients who had major clinical events and died in the hospital ordischarged at the end of the therapy in PE (+) group (p=0.511).Conclusion: Although the ACE levels of patients in PE (+) group were significantlyhigher than healthy volunteers, in ED, the ACE levels could not determine PE statistically andcould not predict the management and prognosis.Key Words: Pulmonary embolism, Angiotensin Converting Enzyme, EmergencyDepartment.