Pulmonary Embolism in Patients with Chronic Obstructive Pulmonary Disease or Congestive Heart Failure

Monréal, Manuel; Muñoz-Torrero, Juan Francisco Sánchez; Naraine, Virjanand S.; Jiménez, David; Soler, Silvia; Rey, Ramón Rabuñal; Gallego, P.

doi:10.1016/j.amjmed.2005.11.035

Cited by 59 publications

(44 citation statements)

References 19 publications

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“…Data from this registry have been used to evaluate outcomes after acute VTE, such as the frequency of recurrent VTE, bleeding and mortality, and risk factors for these outcomes [18][19][20]. We then conducted this study with two goals: 1) to check whether COPD patients really present more frequently with PE rather than DVT; and 2) to define the clinical characteristics and outcome of COPD patients with VTE, compared with patients with VTE but without COPD.…”

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confidence: 99%

Clinical presentation and outcome of venous thromboembolism in COPD

Bertoletti¹,

Quenet²,

Mismetti³

et al. 2011

Eur Respir J

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Chronic obstructive pulmonary disease (COPD) is a moderate risk factor for venous thromboembolism (VTE), but neither the clinical presentation nor the outcome of VTE in COPD patients is well known.The clinical presentation of VTE, namely pulmonary embolism (PE) or deep venous thrombosis (DVT), and the outcome at 3 months (death, recurrent VTE or bleeding) were compared between 2,984 COPD patients and 25,936 non-COPD patients included in the RIETE (Registro Informatizado de la Enfermedad TromboEmbólica) registry. This ongoing international, multicentre registry includes patients with proven symptomatic PE or DVT.PE was the more frequent VTE presentation in COPD patients (n51,761, 59%). PE presentation was more significantly associated with COPD patients than non-COPD patients (OR 1.64, 95% CI 1.49-1.80). During the 3-month follow-up, mortality (10.8% versus 7.6%), minor bleeding (4.5% versus 2.3%) or first VTE recurrences as PE (1.5% versus 1.1%) were significantly higher in COPD patients than in non-COPD patients. PE was the most common cause of death.COPD patients presented more frequently with PE than DVT. It may explain the worse prognosis of COPD patients, with a higher risk of death, bleeding or VTE recurrences as PE compared with non-COPD patients. Further therapeutic options are needed.

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mentioning

confidence: 99%

Clinical presentation and outcome of venous thromboembolism in COPD

Bertoletti¹,

Quenet²,

Mismetti³

et al. 2011

Eur Respir J

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“…The Registro Informatizado de la Enfermedad Tromboembolica (RIETE) registry reported that 14% of patients with confirmed PE also had COPD. 12 In contrast, a recent study reported a low incidence of PE in patients hospitalized for acute exacerbation of COPD: 6.2% of patients with a clinical suspicion of PE, and only 1.3% of those with low suspicion. 13 A meta-analysis found that the prevalence of PE in acute exacerbations of COPD was 19.9%.…”

Section: Discussionmentioning

confidence: 88%

Risk Factors for Venous Thromboembolism in Chronic Obstructive Pulmonary Disease

Kim¹,

Goel²,

Gangar³

et al. 2014

J COPD F

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Background COPD patients are at increased risk for venous thromboembolism (VTE). VTE however remains under-diagnosed in this population and the clinical profile of VTE in COPD is unclear. Methods Global initiative for chronic Obstructive Lung Disease (GOLD) stages II-IV participants in the COPD Genetic Epidemiology (COPDGene) study were divided into 2 groups: VTE+, those who reported a history of VTE by questionnaire, and VTE−, those who did not. We compared variables in these 2 groups with either t-test or chi-squared test for continuous and categorical variables, respectively. We performed a univariate logistic regression for VTE, and then a multivariate logistic regression using the significant predictors of interest in the univariate analysis to ascertain the determinants of VTE. Results The VTE+ group was older, more likely to be Caucasian, had a higher body mass index (BMI), smoking history, used oxygen, had a lower 6-minute walk distance, worse quality of life scores, and more dyspnea and respiratory exacerbations than the VTE− group. Lung function was not different between groups. A greater percentage of the VTE+ group described multiple medical comorbidities. On multivariate analysis, BMI, 6-minute walk distance, pneumothorax, peripheral vascular disease, and congestive heart failure significantly increased the odds for VTE by history. Conclusions BMI, exercise capacity, and medical comorbidities were significantly associated with VTE in moderate to severe COPD. Clinicians should suspect VTE in patients who present with dyspnea and should consider possibilities other than infection as causes of COPD exacerbation.

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“…In the ICOPER registry with 2554 patients, APE accompanying CHF was diagnosed in 10.5% of patients [2]. The presence of CHF in patients with APE worsens their prognosis and is an independent risk factor for death [1,2]. Darze et al [4] observed that APE worsens the prognosis or increases the frequency of hospitalization in a 3-month observation in patients with CHF.…”

Section: Variablesmentioning

confidence: 99%

“…Moreover, patients with APE and coexisting CHF are characterized by a higher mortality rate than APE patients without CHF [1]. In large PE registries, such as ICOPER registry, CHF was observed in 10.5% of patients with APE and was found to be an independent mortality risk factor with a hazard ratio (HR) of 2.4 [2].…”

Section: Introductionmentioning

confidence: 99%