COPD patients presenting with pulmonary embolism (PE) are at increased risk for PE recurrences and fatal PE compared with those presenting with only deep vein thrombosis (DVT), according to French researchers.
Investigators analyzed data from 4036 COPD patients who represented 10.9% of all VTE patients enrolled into the international RIETE study.
During the 3-month follow-up period, they found that COPD patients with PE were two-fold more likely to experience a recurrence as PE, and nearly seven-fold more likely to die from PE, than those with DVT. Additionally, cancer, which was reported among 22% of COPD patients, was an independent risk factor for fatal PE, as was recent immobilization.
The authors also detected a trend for an increased risk for major bleeding in patients with PE, which was reported in 3.0% of PE patients and 2.0% of DVT patients over 3 months; 12.5% of PE patients died from any cause during follow up, significantly more than the 8.7% of DVT patients who died.
“These observations suggest that in COPD initially presenting with PE the major concern should be recurrent (and potentially fatal) PE,” the authors concluded. “As PE is the main cause of death during the 3-month follow-up, there is a huge need for treatment which would be more efficient in terms of PE occurrence but also which would not induce an increase in the bleeding risk.”