Abstract
Background
Factors associated with the detection of raised systolic pulmonary artery pressure
(sPAP) levels in patients with a prior episode of pulmonary embolism (PE) are not
well known.
Methods
We used the RIETE Registry database to identify factors associated with the finding
of sPAP levels ≥50 mm Hg on trans-thoracic echocardiography, in 557 patients with a prior episode of
acute, symptomatic PE.
Results
Sixty-two patients (11.1%; 95% CI: 8.72–14.1) had sPAP levels ≥50 mm Hg. These patients were more likely women, older, and more likely had chronic lung
disease, heart failure, renal insufficiency or leg varicosities than those with PAP
levels <50 mm Hg. During the index PE event, they more likely had recent immobility, and more
likely presented with hypoxemia, increased sPAP levels, atrial fibrillation, or right
bundle branch block. On multivariate analysis, women aged ≥70 years (hazard ratio [HR]: 2.0; 95% CI: 1.0–3.7), chronic heart or chronic lung disease
(HR: 2.4; 95% CI: 1.3–4.4), atrial fibrillation at PE presentation (HR: 2.8; 95% CI:
1.3–6.1) or varicose veins (HR: 1.8; 95% CI: 1.0–3.3) were all associated with an
increased risk to have raised sPAP levels. Chronic heart disease, varicose veins,
and atrial fibrillation were independent predictors in women, while chronic heart
disease, atrial fibrillation, a right bundle branch block or an S1Q3T3 pattern on
the electrocardiogram were independent predictors in men.
Conclusions
Women aged ≥70 years more likely had raised sPAP levels than men after a PE episode. Additional variables
influencing this risk seem to differ according to gender.
Keywords
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Article info
Publication history
Published online: February 27, 2013
Accepted:
January 28,
2013
Received in revised form:
January 27,
2013
Received:
September 26,
2012
Identification
Copyright
© 2013 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
