Pulmonary embolism and 3-month outcomes in 4036 patients with venous thromboembolism and chronic obstructive pulmonary disease: data from the RIETE registry.

Laurent Bertoletti (1, 2, 3) , Sara Quenet (1) , Silvy Laporte (1, 2, 3) , Joan Carles Sahuquillo (4) , Francisco Conget (5) , José María Pedrajas (6) , Mar Martin (7) , Ignacio Casado (8) , Antonio Riera-Mestre (9) , Manuel Monreal (10)

1 GRT - Groupe de recherche sur la thrombose, pharmacologie des antithrombotiques et situations à risque
2 Service de Médecine Thérapeutique
3 CIC-EC 1408 - Centre d'Investigation Clinique - Epidémiologie Clinique [CHU Saint-Etienne]
4 Department of Internal Medicine
5 Department of Pneumonology
6 Department of Internal Medicine
7 Department of Internal Medicine
8 Department of Pneumonology
9 Department of Internal Medicine
10 Department of Internal Medicine

BACKGROUND: 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. METHODS: 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)). RESULTS: 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). CONCLUSIONS: 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.

Mots clés: Chronic obstructive pulmonary diseases; Deep venous thrombosis; Prognosis; Pulmonary embolism; Venous thromboembolism

Domaines: Pneumologie et système respiratoire

Laurent Bertoletti, Sara Quenet, Silvy Laporte, Joan Carles Sahuquillo, Francisco Conget, et al.. Pulmonary embolism and 3-month outcomes in 4036 patients with venous thromboembolism and chronic obstructive pulmonary disease: data from the RIETE registry.. Respiratory Research, 2013, 14 (1), pp.75. ⟨10.1186/1465-9921-14-75⟩. ⟨inserm-00849333⟩