Introduction:
Acute pulmonary embolism (APE) is an emergent cardiothoracic disorder. The PESI score is used to estimate 30-day mortality in patients diagnosed with non-high-risk APE. Also, there are biomarkers for predicting prognosis and mortality in APE. Catestatin (CST) is accepted as a marker ofsympathetic nervous system activity which has been shown that the sympathetic nervous system activation can contribute pathogenesis in APE. So, we attempt herein to investigate the correlation of PE diagnosis and prognostic determination with plasma CST levels in PE patients.

Material and methods:
Blood samples were drawn at admission for laboratory assays and CST measurements. Plasma levels of CST were measured by ELISA according to the manufacturer’s instruction. Transthoracic echocardiography was performed for the assessment of RV dysfunction using a Toshiba Applio 500 echocardiographic system within 24 h of the admission.

Results:
Plasma CST levels were higher in patients with APE than in the control group (17.5 ±6.1 ng/ml vs. 27.3 ±5.7 ng/ml, p < 0.001). Plasma CST levels were higher in the sPESI ≥ 1 (n = 72) than in the patients with sPESI < 1 (37.3 ±6.1 vs. 24.2 ±5.3 ng/ml, p < 0.001). There was a positive correlation between CST level and sPESI score (±0.581, p < 0.001). Mortality occurred in 20 patients with sPESI ≥ 1 (27.7%) and in 9 patients with sPESI < 1 (10.2%) (p = 0.010). Receiver operating characteristic (ROC) curve analysis using a cut-off level of 31.2 ng/ml, and the CST level predicted mortality with a sensitivity of 100% and specificity of 52.6% (AUC = 0.883, 95% CI: 0.689–0.921). Furthermore, the CST level was correlated with right ventricular dysfunction.

Conclusions:
CST can predict sPESI score and mortality in patients with APE.