Comparison of Clinical and Imaging Characteristics and Outcomes between Provoked and Unprovoked Acute Pulmonary Embolism in Koreans.
10.3346/jkms.2012.27.11.1347
- Author:
Jae Sun UHM
1
;
Hae Ok JUNG
;
Chan Joon KIM
;
Tae Hoon KIM
;
Ho Joong YOUN
;
Sang Hong BAEK
;
Wook Sung CHUNG
;
Ki Bae SEUNG
Author Information
1. Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea. hojheart@catholic.ac.kr
- Publication Type:Original Article ; Comparative Study
- Keywords:
CT Obstruction Index;
Provoked;
Pulmonary Embolism;
Unprovoked
- MeSH:
Acute Disease;
Adult;
Aged;
Aged, 80 and over;
Asian Continental Ancestry Group;
C-Reactive Protein/analysis;
Creatinine/blood;
Echocardiography;
Female;
Humans;
Male;
Middle Aged;
Prognosis;
Pulmonary Embolism/diagnosis/mortality/*radiography;
Recurrence;
Renal Insufficiency/complications;
Republic of Korea;
Risk Factors;
Survival Rate;
Tomography, X-Ray Computed
- From:Journal of Korean Medical Science
2012;27(11):1347-1353
- CountryRepublic of Korea
- Language:English
-
Abstract:
This study was performed to compare clinical and imaging parameters and prognosis of unprovoked pulmonary embolism (PE), provoked PE with reversible risk factors (provoked-rRF), and provoked PE with irreversible risk factors (provoked-iRF) in Koreans. Three hundred consecutive patients (mean age, 63.6 +/- 15.0 yr; 42.8% male) diagnosed with acute PE were included. The patients were classified into 3 groups; unprovoked PE, provoked-rRF, and provoked-iRF; 43.7%, 14.7%, and 41.7%, respectively. We followed up the patients for 25.4 +/- 33.7 months. Composite endpoint was all-cause mortality and recurrent PE. The provoked-iRF group had significantly higher all-cause mortality, mortality from PE and recurrent PE than the unprovoked and provoked-rRF groups (P < 0.001, P < 0.001, and P = 0.034, respectively). Prognostic factors of composite endpoint in the unprovoked group were high creatinine (> 1.2 mg/dL; P < 0.001; hazard ratio [HR], 4.735; 95% confidence interval [CI], 1.845-12.152), C-reactive protein (CRP; > 5 mg/L; P = 0.002; HR, 5.308; 95% CI, 1.824-15.447) and computed tomography (CT) obstruction index (P = 0.034; HR, 1.090; 95% CI, 1.006-1.181). In conclusion, provoked-iRF has a poorer prognosis than unprovoked PE and provoked-rRF. Renal insufficiency, high CRP, and CT obstruction index are poor prognostic factors in unprovoked PE.
