Differential clinical manifestations and clinical outcome of cancer-related pulmonary embolism
Background/Aims Although acute pulmonary embolism (PE) adversely impacts survival and should be treated regardless of cancer, the treatment rate of cancer-related PE is relatively low. We aimed to compare clinical characteristics and long term prognosis of PE in patients with or without cancer. Meth...
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| Format: | Article |
| Language: | English |
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The Korean Association of Internal Medicine
2020-03-01
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| Series: | The Korean Journal of Internal Medicine |
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| Online Access: | http://www.kjim.org/upload/pdf/kjim-2018-267.pdf |
| _version_ | 1818600306522456064 |
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| author | Min Sun Kim Haseong Chang Su Yeon Lee Sun Hye Shin HyeYun Park Sung-A Chang Taek Kyu Park Duk-Kyung Kim Eun Kyoung Kim |
| author_facet | Min Sun Kim Haseong Chang Su Yeon Lee Sun Hye Shin HyeYun Park Sung-A Chang Taek Kyu Park Duk-Kyung Kim Eun Kyoung Kim |
| author_sort | Min Sun Kim |
| collection | DOAJ |
| description | Background/Aims Although acute pulmonary embolism (PE) adversely impacts survival and should be treated regardless of cancer, the treatment rate of cancer-related PE is relatively low. We aimed to compare clinical characteristics and long term prognosis of PE in patients with or without cancer. Methods From March 2010 to December 2013, patients with newly diagnosed PE were analyzed. Baseline demographics, comorbidities, cancer status and clinical manifestations of PE were recorded. We defined primary composite outcome as recurrent venous thromboembolism (VTE) and death from PE. Results Among a total of 976 patients with PE, the 703 (72.0%) had cancer-related PE. Cancer-related PE group was more frequently asymptomatic (54.5% vs. 13.2%, p < 0.001), less extensive (involvement of bilateral pulmonary arteries: 42.8% vs. 51.3%, p = 0.017; lung infarction: 5.3% vs. 10.3%, p = 0.005) and less likely to accompany right ventricular dysfunction (10.3% vs. 27.2%, p < 0.001) compared with the non-cancer PE group. Anticoagulation was less frequently underwent in patients with cancer-related PE than those without cancer (62.0% vs. 81.7%, p < 0.001). A composite of recurrent VTE and death from PE was significantly higher in the cancer-related PE group (14.4% vs. 6.6%, p = 0.001). Conclusions Although PE in cancer patients were seem to be less aggressive initially, compared to those without cancer, they had significantly poor prognosis. Given a high rate of recurrent VTE and relatively similar risk of anticoagulation associated bleeding events in cancer patients, more active treatment of PE is warranted in cancer patients. |
| first_indexed | 2024-12-16T12:33:24Z |
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| institution | Directory Open Access Journal |
| issn | 1226-3303 2005-6648 |
| language | English |
| last_indexed | 2024-12-16T12:33:24Z |
| publishDate | 2020-03-01 |
| publisher | The Korean Association of Internal Medicine |
| record_format | Article |
| series | The Korean Journal of Internal Medicine |
| spelling | doaj.art-ae43790320db4c499b3c0a589f78280f2022-12-21T22:31:38ZengThe Korean Association of Internal MedicineThe Korean Journal of Internal Medicine1226-33032005-66482020-03-0135236036810.3904/kjim.2018.267170223Differential clinical manifestations and clinical outcome of cancer-related pulmonary embolismMin Sun Kim0Haseong Chang1Su Yeon Lee2Sun Hye Shin3HyeYun Park4Sung-A Chang5Taek Kyu Park6Duk-Kyung Kim7Eun Kyoung Kim8 Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Division of Pulmonology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Division of Pulmonology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaBackground/Aims Although acute pulmonary embolism (PE) adversely impacts survival and should be treated regardless of cancer, the treatment rate of cancer-related PE is relatively low. We aimed to compare clinical characteristics and long term prognosis of PE in patients with or without cancer. Methods From March 2010 to December 2013, patients with newly diagnosed PE were analyzed. Baseline demographics, comorbidities, cancer status and clinical manifestations of PE were recorded. We defined primary composite outcome as recurrent venous thromboembolism (VTE) and death from PE. Results Among a total of 976 patients with PE, the 703 (72.0%) had cancer-related PE. Cancer-related PE group was more frequently asymptomatic (54.5% vs. 13.2%, p < 0.001), less extensive (involvement of bilateral pulmonary arteries: 42.8% vs. 51.3%, p = 0.017; lung infarction: 5.3% vs. 10.3%, p = 0.005) and less likely to accompany right ventricular dysfunction (10.3% vs. 27.2%, p < 0.001) compared with the non-cancer PE group. Anticoagulation was less frequently underwent in patients with cancer-related PE than those without cancer (62.0% vs. 81.7%, p < 0.001). A composite of recurrent VTE and death from PE was significantly higher in the cancer-related PE group (14.4% vs. 6.6%, p = 0.001). Conclusions Although PE in cancer patients were seem to be less aggressive initially, compared to those without cancer, they had significantly poor prognosis. Given a high rate of recurrent VTE and relatively similar risk of anticoagulation associated bleeding events in cancer patients, more active treatment of PE is warranted in cancer patients.http://www.kjim.org/upload/pdf/kjim-2018-267.pdfpulmonary embolismvenous thromboembolismneoplasms |
| spellingShingle | Min Sun Kim Haseong Chang Su Yeon Lee Sun Hye Shin HyeYun Park Sung-A Chang Taek Kyu Park Duk-Kyung Kim Eun Kyoung Kim Differential clinical manifestations and clinical outcome of cancer-related pulmonary embolism The Korean Journal of Internal Medicine pulmonary embolism venous thromboembolism neoplasms |
| title | Differential clinical manifestations and clinical outcome of cancer-related pulmonary embolism |
| title_full | Differential clinical manifestations and clinical outcome of cancer-related pulmonary embolism |
| title_fullStr | Differential clinical manifestations and clinical outcome of cancer-related pulmonary embolism |
| title_full_unstemmed | Differential clinical manifestations and clinical outcome of cancer-related pulmonary embolism |
| title_short | Differential clinical manifestations and clinical outcome of cancer-related pulmonary embolism |
| title_sort | differential clinical manifestations and clinical outcome of cancer related pulmonary embolism |
| topic | pulmonary embolism venous thromboembolism neoplasms |
| url | http://www.kjim.org/upload/pdf/kjim-2018-267.pdf |
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