Symptomatic subsegmental versus more central pulmonary embolism: Clinical outcomes during anticoagulation

The RIETE Investigators.

Detalles Bibliográficos
Autores: Fernández‐Capitán, Carmen, Rodriguez Cobo, Ana, Jiménez, David, Madridano, Olga, Ciammaichella, Maurizio, Usandizaga, Esther, Otero Candelera, Remedios, Di Micco, Pierpaolo, Moustafa, Fares, Monreal, Manuel
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Consejo Superior de Investigaciones Científicas (CSIC)
Repositorio:DIGITAL.CSIC. Repositorio Institucional del CSIC
OAI Identifier:oai:digital.csic.es:10261/239991
Acceso en línea:http://hdl.handle.net/10261/239991
Access Level:acceso abierto
Palabra clave:Anticoagulants
Deep vein thrombosis
Outcomes
Pulmonary embolism
Subsegmental
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spelling Symptomatic subsegmental versus more central pulmonary embolism: Clinical outcomes during anticoagulationFernández‐Capitán, CarmenRodriguez Cobo, AnaJiménez, DavidMadridano, OlgaCiammaichella, MaurizioUsandizaga, EstherOtero Candelera, RemediosDi Micco, PierpaoloMoustafa, FaresMonreal, ManuelAnticoagulantsDeep vein thrombosisOutcomesPulmonary embolismSubsegmentalThe RIETE Investigators.[Background] The optimal therapy of patients with acute subsegmental pulmonary embolism (PE) is controversial.[Methods] We used the RIETE (Registro Informatizado Enfermedad TromboEmbólica) database to compare the rate of symptomatic PE recurrences during anticoagulation in patients with subsegmental, segmental, or more central PEs. [Results] Among 15 963 patients with a first episode of symptomatic PE, 834 (5.2%) had subsegmental PE, 3797 (24%) segmental, and 11 332 (71%) more central PE. Most patients in all subgroups received initial therapy with low‐molecular‐weight heparin, and then most switched to vitamin K antagonists. Median duration of therapy was 179, 185, and 204 days, respectively. During anticoagulation, 183 patients developed PE recurrences, 131 developed deep vein thrombosis (DVT), 543 bled, and 1718 died (fatal PE, 135). The rate of PE recurrences was twofold higher in patients with subsegmental PE than in those with segmental (hazard ratio [HR], 2.13; 95% confidence interval [CI], 1.16‐3.85) or more central PE (HR, 1.89; 95% CI, 1.12‐3.13). On multivariable analysis, patients with subsegmental PE had a higher risk for PE recurrences than those with central PE (adjusted HR, 1.75; 95% CI, 1.02‐3.03). After stratifying patients with subsegmental PE according to ultrasound imaging in the lower limbs, the rate of PE recurrences was similar in patients with DVT, in patients without DVT, and in those with no ultrasound imaging. [Conclusions] Our study reveals that the risk for PE recurrences in patients with segmental PE is not lower than in those with more central PE, thus suggesting that the risk of PE recurrences is not influenced by the anatomic location of PE.John Wiley & SonsConsejo Superior de Investigaciones Científicas [https://ror.org/02gfc7t72]2021202120212021info:eu-repo/semantics/articlehttp://purl.org/coar/resource_type/c_6501Publisher's versioninfo:eu-repo/semantics/publishedVersionhttp://hdl.handle.net/10261/239991reponame:DIGITAL.CSIC. Repositorio Institucional del CSICinstname:Consejo Superior de Investigaciones Científicas (CSIC)Ingléshttp://doi.org/10.1002/rth2.12446Síinfo:eu-repo/semantics/openAccessoai:digital.csic.es:10261/2399912026-05-22T06:33:51Z
dc.title.none.fl_str_mv Symptomatic subsegmental versus more central pulmonary embolism: Clinical outcomes during anticoagulation
title Symptomatic subsegmental versus more central pulmonary embolism: Clinical outcomes during anticoagulation
spellingShingle Symptomatic subsegmental versus more central pulmonary embolism: Clinical outcomes during anticoagulation
Fernández‐Capitán, Carmen
Anticoagulants
Deep vein thrombosis
Outcomes
Pulmonary embolism
Subsegmental
title_short Symptomatic subsegmental versus more central pulmonary embolism: Clinical outcomes during anticoagulation
title_full Symptomatic subsegmental versus more central pulmonary embolism: Clinical outcomes during anticoagulation
title_fullStr Symptomatic subsegmental versus more central pulmonary embolism: Clinical outcomes during anticoagulation
title_full_unstemmed Symptomatic subsegmental versus more central pulmonary embolism: Clinical outcomes during anticoagulation
title_sort Symptomatic subsegmental versus more central pulmonary embolism: Clinical outcomes during anticoagulation
dc.creator.none.fl_str_mv Fernández‐Capitán, Carmen
Rodriguez Cobo, Ana
Jiménez, David
Madridano, Olga
Ciammaichella, Maurizio
Usandizaga, Esther
Otero Candelera, Remedios
Di Micco, Pierpaolo
Moustafa, Fares
Monreal, Manuel
author Fernández‐Capitán, Carmen
author_facet Fernández‐Capitán, Carmen
Rodriguez Cobo, Ana
Jiménez, David
Madridano, Olga
Ciammaichella, Maurizio
Usandizaga, Esther
Otero Candelera, Remedios
Di Micco, Pierpaolo
Moustafa, Fares
Monreal, Manuel
author_role author
author2 Rodriguez Cobo, Ana
Jiménez, David
Madridano, Olga
Ciammaichella, Maurizio
Usandizaga, Esther
Otero Candelera, Remedios
Di Micco, Pierpaolo
Moustafa, Fares
Monreal, Manuel
author2_role author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Consejo Superior de Investigaciones Científicas [https://ror.org/02gfc7t72]
dc.subject.none.fl_str_mv Anticoagulants
Deep vein thrombosis
Outcomes
Pulmonary embolism
Subsegmental
topic Anticoagulants
Deep vein thrombosis
Outcomes
Pulmonary embolism
Subsegmental
description The RIETE Investigators.
publishDate 2021
dc.date.none.fl_str_mv 2021
2021
2021
2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
http://purl.org/coar/resource_type/c_6501
Publisher's version
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10261/239991
url http://hdl.handle.net/10261/239991
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv http://doi.org/10.1002/rth2.12446
Sí
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv John Wiley & Sons
publisher.none.fl_str_mv John Wiley & Sons
dc.source.none.fl_str_mv reponame:DIGITAL.CSIC. Repositorio Institucional del CSIC
instname:Consejo Superior de Investigaciones Científicas (CSIC)
instname_str Consejo Superior de Investigaciones Científicas (CSIC)
reponame_str DIGITAL.CSIC. Repositorio Institucional del CSIC
collection DIGITAL.CSIC. Repositorio Institucional del CSIC
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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