Deep vein trombosis in patients with pulmonary trombembolism and prognosis

Objective: In patients with acute pulmonary thrombo-embolism (APE) various studies have shown an asso-ciation between the coexistence of deep vein thrombo-sis (DVT) and short-term prognosis. It is not known whether this association improves short term risk stra-tification.
Methods: We prospectively evaluated 91 normotensive patients diagnosed with APE which, based on the PESI score (class III-V), were in the intermediate risk group. The diagnosis of DVT was made by using venous ultra-sound. Central DVT was considered present when the thrombus was located in the femoral veins.
Results: The mean age of the analyzed population was 67±13.3 years. 61.5% of the subjects were female. In-hospital mortality of the entire lot was 15.4% and 14.4% received fibrinolytic therapy. 42.8% of the patients had DVT at the time of presentation, of which 2.6% bilate-ral and 56.4% had a central location of the thrombus at the level of the lower limbs. For patients undergoing analysis, the presence of DVT was not associated with an increase in short-term mortality. By analyzing se-parately the groups of patients with high and low in-termediate risk, the presence of DVT did not correlate with adverse events, including in-hospital death, in ne-ither of the two groups.
Conclusions: In the studied group, the association with the thrombotic load assessed by vascular ultraso-nography did not reclassify the patients into a higher risk group with additional therapeutic indications. A composite risk score, consisting of information on the presence of DVT, myocardial injury and right ventri-cular dysfunction may offer advantages compared to each test independently in intermediate risk patients and confirmed APE.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)