Key result
Initial PE in COPD linked to ~104% increase in recurrent PE risk vs. DVT alone.
Why the study?
COPD patients with VTE have a modified clinical presentation and worse prognosis than non-COPD patients, necessitating evaluation of initial VTE presentation impact on outcomes.
Does initial presentation with acute PE compared to DVT alone increase the risk of adverse outcomes at 3 months in patients with VTE and COPD?
Cohort (n=4,036)
Yes
Does initial presentation with acute PE compared to DVT alone increase the risk of adverse outcomes at 3 months in patients with VTE and COPD?
In COPD patients with VTE, initial presentation with PE is associated with a significantly higher risk of recurrent PE and fatal PE at 3 months compared to DVT alone.
Answers are grounded in this paper and cite their sources.
May support closer surveillance in COPD patients with initial PE; leaves open optimal secondary prevention strategies.
BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) have a modified clinical presentation of venous thromboembolism (VTE) but also a worse prognosis than non-COPD patients with VTE. As it may induce therapeutic modifications, we evaluated the influence of the initial VTE presentation on the 3-month outcomes in COPD patients. METHODS: COPD patients included in the on-going world-wide RIETE Registry were studied. The rate of pulmonary embolism (PE), major bleeding and death during the first 3 months in COPD patients were compared according to their initial clinical presentation (acute PE or deep vein thrombosis (DVT)). RESULTS: Of the 4036 COPD patients included, 2452 (61%; 95% CI: 59.2-62.3) initially presented with PE. PE as the first VTE recurrence occurred in 116 patients, major bleeding in 101 patients and mortality in 443 patients (Fatal PE: first cause of death). Multivariate analysis confirmed that presenting with PE was associated with higher risk of VTE recurrence as PE (OR, 2.04; 95% CI: 1.11-3.72) and higher risk of fatal PE (OR, 7.77; 95% CI: 2.92-15.7). CONCLUSIONS: COPD patients presenting with PE have an increased risk for PE recurrences and fatal PE compared with those presenting with DVT alone. More efficient therapy is needed in this subtype of patients.
No takes yet. Share an insight, caveat, or question.
Bertoletti et al. (2013) conducted a cohort in Venous thromboembolism and chronic obstructive pulmonary disease (n=4,036). Initial presentation with acute pulmonary embolism vs. Initial presentation with deep vein thrombosis alone was evaluated on VTE recurrence as pulmonary embolism (OR 2.04, 95% CI 1.11-3.72). Initial presentation with pulmonary embolism in COPD patients was associated with a higher risk of VTE recurrence as PE and fatal PE compared to DVT alone.
Synapse has enriched 10 related papers. Consider them for comparative context: