Journal
JOURNAL OF CARDIOLOGY
Volume 77, Issue 4, Pages 395-403Publisher
ELSEVIER
DOI: 10.1016/j.jjcc.2020.10.019
Keywords
Deep venous thrombosis; Pulmonary embolism; Mortality; Recurrence; Bleeding
Categories
Funding
- independent clinical research organization (Research Institute for Production Development, Kyoto, Japan)
- Mitsubishi Tanabe Pharma Corporation (Osaka, Japan)
Ask authors/readers for more resources
The study revealed that acute PE patients with concomitant proximal DVT have a higher short-term mortality risk compared to those without DVT, while the risk for short-term mortality is not significantly different between distal DVT patients and patients without DVT.
Background: The majority of acute pulmonary embolism (PE) is caused by thrombus developed from leg veins. However, impact of concomitant deep venous thrombosis (DVT) on clinical outcomes has not been fully evaluated in patients with acute PE. Methods: The COMMAND VTE Registry is a multicenter registry enrolling consecutive 3027 patients with acute symptomatic venous thromboembolism (VTE) in Japan. The current study population consisted of 655 acute PE patients who underwent lower extremities ultrasound examination at diagnosis for the assessment of concomitant DVT status. Results: There were 424 patients with proximal DVT (64.7%), 162 patients with distal DVT (24.7%), and 69 patients with no DVT (10.5%). The cumulative 90-day incidence of all-cause death was higher in proximal DVT patients than in distal DVT and no DVT patients (7.9%, 2.5%, and 1.4%, p = 0.01). Regarding the causes of death, the cumulative 90-day incidence of PE-related death was low, and not significantly different across the 3 groups (1.4%, 0.6%, and 1.7%, p = 0.62). The most frequent cause of death was cancer in proximal and distal DVT patients. There were no significant differences in 90-day rates of recurrent VTE and major bleeding, regardless of the status of concomitant DVT (2.9%, 3.2%, and 2.2%, p = 0.79, and 1.5%, 4.4%, and 4.9%, p = 0.46, respectively). Conclusions: Acute PE with proximal DVT at diagnosis was associated with a higher risk for short-term mortality than in patients without DVT, while the risk for short-term mortality was not significantly different between distal DVT patients and patients without DVT. (c) 2020 Published by Elsevier Ltd on behalf of Japanese College of Cardiology.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available