Pulmonary embolism was identified in 24% (5 of 21) of patients with uncontrolled asthma despite optimal treatment, highlighting it as a relevant comorbidity to consider.
Observational (n=21)
Pulmonary embolism was found in 24% of patients with uncontrolled asthma, highlighting it as a relevant comorbidity to investigate in difficult-to-treat cases.
Asthma comorbidities (AC), have been associated with greater healthcare use, decreased quality of life and poor asthma control. Treating AC has been shown to improve asthma outcomes as well as overall health. Recent works suggest that pulmonary embolism (PE) must be considered in poorly controlled asthma. The aim of this study was to evaluate the incidence of PE in patients with uncontrolled asthma. We review new patients (pts) referred to our Outpatients Clinics, between January 2011 and June 1st 2012, and selected the ones who mantains uncontrolled asthma despite optimal treatment (ACQ > 1.5). From a total of 21 pts with asthma who fulfilled the criteria of inclusion, we identified 5 pts (24%) with PE, (mean age 48 years, 4 females), 2 of them have prednisone dependent asthma. The mean time until the diagnosis of PE was 6 months. Predisposing factors for PE where, oral contraceptive use, venous insufficiency, and obesity. Three pts have a sub acute/chronic presentation and two an acute form of PE. The initial diagnosis was made by CT (2 pts) and ventilation/perfusion lung scan (3 pts). All pts received oral anticoagulant therapy (OAC) for at least 6 months (suspension was considered if a lung scan and normal D-dimers excluded new PE). It should be noted that despite OAC, only one patient achieved good asthma control. There were 2 hospital admissions, from severe asthma exacerbations, after the beginning of OAC. This study supports the inclusion of PE as a relevant AC to consider, while investigating severe and difficult to treat asthma. In our small sample of pts, PE was a major cause of morbidity, predisposing to lack of control and future risk.
Meneses et al. (Sun,) conducted a observational in Uncontrolled asthma (n=21). Evaluation for pulmonary embolism was evaluated on Incidence of pulmonary embolism. Pulmonary embolism was identified in 24% (5 of 21) of patients with uncontrolled asthma despite optimal treatment, highlighting it as a relevant comorbidity to consider.