Valor pronóstico del antecedente de insuficiencia cardiaca en pacientes ingresados con tromboembolia pulmonar

Lozano-Cruz, Patricia; Vivas, David; Rojas, Alexis Sossa; Font, Rebeca; Román-García, Feliciano; Munoz, B. Igual

doi:10.1016/j.medcli.2016.06.034

Cited by 2 publications

(1 citation statement)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In exploring prognostic differences among patients with HF, increasing attention has been given to LVEF as a distinguishing factor, and several studies suggest considering patients with reduced LVEF as a subgroup with a worse prognosis [ 21 , 41 ]. In the context of PE, some authors claim that reduced LVEF has independent predictive value for in-hospital mortality, which is not the case for patients with preserved LVEF [ 9 , 25 , 42 ]. Additionally, reduced myocardial contractility and the use of beta-blockers in patients with reduced LVEF can worsen their inotropic and chronotropic responses to PE.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Heart Failure in Acute Pulmonary Embolism: A Comprehensive Assessment of 30-Day Outcomes

Farid-Zahran,

Méndez-Bailón,

Pedrajas

et al. 2024

JCM

View full text Add to dashboard Cite

Introduction: Patients with heart failure (HF) are known to have an increased risk of pulmonary embolism (PE), but there is limited evidence regarding the prognostic implications of HF in patients with acute PE and the relationship between PE prognosis and left ventricular ejection fraction (LVEF). The primary objective of this study was the development of a composite outcome (mortality, major bleeding, and recurrence) within the first 30 days. The secondary objective was to identify the role of LVEF in predicting the development of early complications in patients with both HF and reduced LVEF. Material and Methods: A prospective study was conducted at two tertiary hospitals between January 2012 and December 2022 to assess differences among patients diagnosed with acute PE based on the presence or absence of a history of HF. Cox regression models were employed to assess the impact of HF and reduced LVEF on the composite outcome at 30 days. Results: Out of 1991 patients with acute symptomatic PE, 7.13% had a history of HF. Patients with HF were older and had more comorbidities. The HF group exhibited higher mortality (11.27% vs. 4.33%, p < 0.001) and a higher incidence of major bleeding (9.86% vs. 4.54%, p = 0.005). In the multivariate analysis, HF was an independent risk factor for the development of the composite outcome (HR 1.93; 95% CI 1.35–2.76). Reduced LVEF was independently associated with a higher risk of major bleeding (HR 3.44; 95% CI 1.34–8.81). Conclusion: In patients with acute pulmonary embolism, heart failure is independently associated with a higher risk of early complications. Additionally, heart failure with reduced LVEF is an independent risk factor for major bleeding.

show abstract