Long-term prognosis in patients with pulmonary embolism

Venous thromboembolism (VTE), clinically expressed as deep vein thrombosis (DVT) or pulmonary embolism (PE), is, globally, the third most common acute cardiovascular syndrome after myocardial infarction and stroke. Pulmonary embolism is associated with high morbidity and mortality. The long-term prognosis of these patients is insufficiently studied.Aim: To analyze mortality and clinical events at long-term follow-up in patients with confirmed PE. Material and methods: The study included 168 patients with PE, 53% men and 47% women, mean age 61.2±12.8 years, consecutively hospitalized in the Institute of Cardiology. Patients were classified into four risk groups according to the 2019 European Society of Cardiology Guidelines. Patients were followed-up for a mean period of 11.4±0.9 months. Results. During the study period died 23 people (13.7%), 8 of them during hospitalization and another 15 - after discharge from the hospital; in the latter, death occurred suddenly - in 4 cases (26.6%), it was due to cardiovascular causes- in 4 cases (26.6%), through cancer - in 5 (30%) people and from other causes - in 2 (13.3%) patients. Recurrent VTE was observed in 4 (2.5%) subjects, including PE - in 3 and DVT in 1 patient. During the surveillance period 4 (2.5%) patients developed stroke, 5 (3.1%) - acute myocardial infarction, 1 (0.2%) patient - another arterial event. Hemorrhagic complications suffered 20 patients. Chronic thromboembolic pulmonary hypertension was detected in 12.4% of people over 5.4±2.8 months after primary PE. Newly diagnosed cancer was observed in 2 (1.25%) people.Conclusions. The mortality rate in PE patients over an average period of 11.4±0.9 months was 13.7%, including 4.7% - in hospital and 8.9% - at long-term follow-up; in-hospital death was significantly higher in patients in the high and intermediate high risk category compared to those with intermediate-low and low risk and no statistically significant differences were established between these groups in the long-term mortality rate; the main cause of death in the hospital was PE, and during the surveillance period death from cardiovascular causes predominated, followed by death from cancer.