In adults with acute pulmonary embolism, cancer was associated with significantly higher late mortality (38.7% vs 3.3%; p<0.001) but similar early mortality compared to non-cancer patients.
Cohort (n=226)
Yes
Does coexisting cancer affect mortality, recurrence, and bleeding risks in adults admitted with acute pulmonary embolism?
In patients with acute pulmonary embolism, coexisting cancer is associated with significantly higher late mortality and higher NT-proBNP levels, but lower DOAC utilization compared to non-cancer patients.
Absolute Event Rate: 17.9% vs 13.3%
p-value: p=0.341
Background/Objectives: Pulmonary embolism (PE) remains a leading cause of morbidity and mortality, with outcomes influenced by patient demographics, comorbidities, and anticoagulation strategy. While vitamin K antagonists (VKA) have been standard therapy, direct oral anticoagulants (DOACs) are increasingly adopted, yet real-world data in cancer-associated and non-cancer populations are limited. This study aimed to compare demographics, clinical features, therapeutic strategies, and outcomes between oncologic patients with acute PE (experimental group) and non-cancer patients with PE (control group). Methods: We performed a multicentric retrospective cohort study of adults admitted with acute PE between January 2019 and December 2021. The cohort comprised 120 non-cancer and 106 cancer patients. Standard management was low-molecular-weight heparin with transition to (VKA) or (DOAC), when not contraindicated. Data on demographics, comorbidities, and laboratory biomarkers (including NT-proBNP, threshold 600 pg/mL) were analyzed. Primary outcomes were early (≤30 days) and late (31–365 days) all-cause mortality. Secondary outcomes included PE recurrence and bleeding events. Results: Among 226 PE patients (non-oncological n = 120; oncological n = 106), the cancer group was older (69.2 ± 12.6 vs. 62.6 ± 17.3 years; p = 0.001) with similar ECG findings and hemodynamic stability at presentation. NT-proBNP > 600 pg/mL was more frequent in cancer (37.7% vs. 23.3%; p = 0.018), whereas D-dimer > 5 mg/L was more common in non-cancer (74.2% vs. 55.7%; p = 0.003). DOAC use was lower in cancer patients (40.6% vs. 65.0%; p 5 mg/L (OR 0.35, 95% CI 0.19–0.64; p < 0.001). Conclusions: Prompt anticoagulation was associated with lower early mortality, while differences in late mortality appeared to be largely confounded by age and cancer status. NT-proBNP may serve as a useful risk-stratification biomarker, but confirmation in larger, prospective studies is required.
Nemțuț et al. (Tue,) conducted a cohort in Acute pulmonary embolism (n=226). Cancer vs. Non-cancer was evaluated on Early (≤30 days) all-cause mortality (p=0.341). In adults with acute pulmonary embolism, cancer was associated with significantly higher late mortality (38.7% vs 3.3%; p<0.001) but similar early mortality compared to non-cancer patients.