Pulmonary embolism and 3-month outcomes in 4036 patients with venous thromboembolism and chronic obstructive pulmonary disease: data from the RIETE registry
- Equal contributors
1 Thrombosis Research Group, EA3065, University Saint-Etienne, Jean Monnet, Saint-Etienne F-42023, France
2 CIE3, INSERM, Saint-Etienne F- 42055, France
3 Department of Therapeutic Medicine, CHU Saint-Etienne, Hôpital Nord, Saint-Etienne F-42055, France
4 Department of Internal Medicine, Hospital Municipal de Badalona, Barcelona, Spain
5 Department of Pneumonology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
6 Department of Internal Medicine, Hospital Clínico San Carlos, Madrid, Spain
7 Department of Internal Medicine, Hospital Infanta Sofía, Madrid, Spain
8 Department of Pneumonology, Hospital Universitario Virgen de las Nieves, Granada, Spain
9 Department of Internal Medicine, Hospital Univesitari de Bellvitge - IDIBELL, Barcelona, Spain
10 Department of Internal Medicine, Hospital Universitari Germans Trias I Pujol, Badalona, Spain
Respiratory Research 2013, 14:75 doi:10.1186/1465-9921-14-75Published: 18 July 2013
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.
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)).
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).
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.