Preventive cardiology
Abstract
A Prospective Study on Cardiovascular Events After Acute Pulmonary Embolism

https://doi.org/10.1016/j.accreview.2005.04.018Get rights and content

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Study Question

How frequently do patients with a pulmonary embolism have subsequent cardiovascular (CV) events?

Methods

A total of 360 patients with a first episode of pulmonary embolism (PE) were included in a prospective study: 209 with idiopathic PE and 151 with PE associated with transient risk factors. The study outcomes were CV events (recurrent venous thromboembolism [VTE], acute myocardial infarction [AMI], stroke, sudden otherwise unexplained death), CV death, and death due to any cause. The median follow-up was 38 months.

Results

Mean age was 62 years, and those with idiopathic PE were older. Deep vein thrombosis (DVT) was present in 68%, hypertension in 42%, hyperlipidemia in 30%, and smoking in 29% of subjects. Sixty-four patients had at least one CV event (5.5% patient-year). Recurrent VTE occurred in 45 patients (3.9% patient-year), AMI in 12 patients (1.0% patient-year), stroke in 6 patients (0.5% patient-year) and sudden otherwise unexplained death in 4 patients (0.3% patient-year). A CV event occurred in 47

Conclusions

Cardiovascular events are more common in patients with idiopathic PE than in patients with PE associated with transient risk factors. Cardiovascular events are the major cause of death in patients with idiopathic PE.

Perspective

The conclusion that there is an increase in CV events in patients with PE is not supported by the data. If one eliminates recurrent VTE as a CV event, the risk of other CV events (MI, stroke, sudden death) is consistent with the risk factors in this cohort. MR

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