Prevalence of heart diseases in patients with pulmonary embolism with and without peripheral venous thrombosis: Findings from a cross-sectional survey

Prandoni, Paolo; Pesavento, Raffaele; Sørensen, Henrik T.; Gennaro, Nicola; Dalla Valle, Fabio; Minotto, Isabella; Perina, Fabio; Pengo, Vittorio; Pagnan, Antonio

doi:10.1016/j.ejim.2009.06.001

« Previous Next »European Journal of Internal Medicine
Volume 20, Issue 5 , Pages 470-473, September 2009

Prevalence of heart diseases in patients with pulmonary embolism with and without peripheral venous thrombosis:

Findings from a cross-sectional survey

Paolo Prandoni
- Department of Cardiothoracic and Vascular Sciences, University of Padua, Italy
- Corresponding author. Department of Cardiothoracic and Vascular Sciences, Thromboembolism Unit, University of Padua, Via Giustiniani 2, 35128, Padua, Italy. Tel.: +39 049 8212656; fax: +39 049 8218731.
Raffaele Pesavento
- Department of Cardiothoracic and Vascular Sciences, University of Padua, Italy
Henrik T. Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, 8000 Aarhus C, Denmark
Nicola Gennaro
- Department of Epidemiology, Public Health Agency, Regione Veneto, Italy
Fabio Dalla Valle
- Department of Cardiothoracic and Vascular Sciences, University of Padua, Italy
Isabella Minotto
- Department of Cardiothoracic and Vascular Sciences, University of Padua, Italy
Fabio Perina
- Health Information Systems, Department for Health Resources, Social Services and Information Systems, Regione Veneto, Italy
Vittorio Pengo
- Department of Cardiothoracic and Vascular Sciences, University of Padua, Italy
Antonio Pagnan
- Department of Cardiothoracic and Vascular Sciences, University of Padua, Italy

Received 30 January 2009; received in revised form 4 June 2009; accepted 10 June 2009. published online 06 July 2009.

Abstract

Background

In up to 80% of patients with pulmonary embolism (PE) no peripheral symptomatic thrombosis can be identified. Whether the heart may represent a source of PE is unknown.

Methods

We conducted a cross-sectional survey of patients who were 60years or older and were discharged from the hospitals of Veneto region, Italy between 2000 and 2006 with the diagnosis of PE. We compared the prevalence of several acute and chronic heart diseases in patients discharged with the diagnosis of PE alone with that of patients with co-occurring symptomatic peripheral deep venous thrombosis (PE/DVT).

Results

Out of 11,236 eligible patients, 9079 (81%) were discharged with the diagnosis of PE alone, and 2157 with that of PE/DVT. 3239 of the 9079 (35.7%) patients with isolated PE, and 666 of the 2157 (30.9%) with PE/DVT had at least one heart disease. The adjusted odds ratio (OR) for having at least one heart disease in patients with isolated PE as compared to those with PE/DVT was 1.26 (95% CI, 1.13–1.40). The heart diseases that significantly contributed to the study results were all-cause cardiomyopathies (adjusted OR, 2.31; 95% CI, 1.37–3.89), all-cause heart failure (1.82; 1.45–2.27), coronary heart disease (1.28; 1.08–1.52), and atrial fibrillation or flutter (1.28; 1.08–1.51).

Conclusions

There is an association between isolated PE and a number of heart diseases. The results of our survey generate the hypothesis that in older patients several heart diseases may directly account for the development of PE. Prospective studies are needed to confirm this hypothesis.

Keywords: Pulmonary embolism, Deep venous thrombosis, Cardiomyopathy, Heart failure, Coronary heart disease, Atrial fibrillation