Photo Credit: brgfx

The following is a summary of “Baseline characteristics, management patterns and outcome in patients with pulmonary embolism and malignancy: Insights from a single-centre study,” published in the November 2024 issue of Cardiology by Hakgor et al.   

Acute pulmonary embolism (PE) is a major cause of death in patients with active cancer, significantly impacting treatment decisions and survival outcomes.  

Researchers conducted a retrospective study to evaluate the impact of active cancer on treatment choices and clinical outcomes in patients with acute PE.  

They analyzed 872 patients with acute PE (mean age 61.6 ± 16.8 years; 57.5% female), dividing them based on active cancer status. Treatment methods included ultrasound-assisted thrombolysis (USAT), rheolytic thrombectomy (RT), systemic thrombolysis (ST), and anticoagulation alone.  

The results showed 129 (14.8%) patients with active malignancy of 872. Across all patients with PE, treatments included USAT (27.3%), RT (16.6%), ST (6.4%), and anticoagulation alone (49.7%), RT and anticoagulation were more common in patients with malignancy. At the same time, ST and USAT were more frequently used in the non-cancer group. Treatment targets were significantly improved regardless of malignancy or treatment method (P< 0.001 for all). Bleeding rates were similar between groups. However, in-hospital and long-term mortality were higher in patients with cancer. Active malignancy independently predicted the composite of 60-day mortality and PE-related rehospitalization (aOR: 2.43; 95% CI: 1.32–4.47, P=0.04) and long-term mortality (aHR: 2.25; 95% CI: 1.29–3.91, P=0.004).  

They concluded that active malignancy negatively affected both short- and long-term outcomes in patients with acute PE, although satisfactory results can be achieved with catheter-based methods, maintaining acceptable bleeding rates.  

Source: internationaljournalofcardiology.com/article/S0167-5273(24)01341-X/abstract