Advertisement

Gender Differences Among Patients With Acute Pulmonary Embolism

      Gender differences in patients with acute pulmonary embolism (APE) remain unclear and controversial. We aimed to understand the gender differences in patients with APE treated in the cardiovascular care units. The registry database of 1,428 patients with APE treated at the Tokyo cardiovascular care unit Network institutions from 2010 to 2014 was retrieved for analysis. In all, 795 women (55.7%) and 633 men (44.3%) were included in this study. The women were older than men (68.0 ± 16.1 vs 60.9 ± 15.6 years, p < 0.0001). Compared with men, women had more complaints of dyspnea and disturbed consciousness, lesser complaints of leg symptoms, and chest pain. Pulmonary arterial systolic pressure (51.5 ± 22.2 mm Hg vs 47.4 ± 22.4 mm Hg, p = 0.012) and the serum B-type natriuretic peptide level (180.4 [50.7 to 526.1] pg/ml vs 107.0 [25.0 to 306.8] pg/ml, p < 0.0001) on admission, was higher in women than in men. Severe cases with massive embolism were seen more in women compared with men (14.6% vs 9.2%, p = 0.0002). The use of inferior vena cava filters were lower in women than in men (31.9% vs 37.3%, p = 0.029). Furthermore, 30-day PE-related mortality was higher in women than in men significantly (5.0% vs 2.8%, p = 0.043). In conclusion, women APE patients were older with higher severity than men APE patients, resulting in poor prognosis.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      Reference

        • Anderson FA
        • Zayaruzny M
        • Heit JA
        • Fidan D
        • Cohen AT
        Estimated annual numbers of US acute-care hospital patients at risk for venous thromboembolism.
        Am J Hematol. 2007; 82: 777-782
        • Cohen AT
        • Agnelli G
        • Anderson FA
        • Arcelus JI
        • Bergqvist D
        • Brecht JG
        • Greer IA
        • Heit JA
        • Hutchinson JL
        • Kakkar AK
        • Mottier D
        • Oger E
        • Samama MM
        • Spannagl M
        • VTE Impact Assessment Group in Europe (VITAE)
        Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality.
        Thromb Haemost. 2007; 98: 756-764
        • Liao S
        • Woulfe T
        • Hyder S
        • Merriman E
        • Simpson D
        • Chunilal S
        Incidence of venous thromboembolism in different ethnic groups: a regional direct comparison study.
        J Thromb Haemost. 2014; 12: 214-219
        • JCS Joint Working Group
        Guidelines for the diagnosis, treatment and prevention of pulmonary thromboembolism and deep vein thrombosis (JCS2009).
        Circ J. 2011; 75: 1258-1281
        • Nakamura M
        • Miyata T
        • Ozeki Y
        • Takayama M
        • Komori K
        • Yamada N
        • Origasa H
        • Satokawa H
        • Maeda H
        • Tanabe N
        • Unno N
        • Shibuya T
        • Tanemoto K
        • Kondo K
        • Kojima T.
        Current venous thromboembolism management and outcomes in Japan.
        Circ J. 2014; 78: 708-717
        • Horlander KT
        • Mannino DM
        • Leeper KV
        Pulmonary embolism mortality in the United States, 1979–1998: an analysis using multiple-cause mortality data.
        Arch Intern Med. 2003; 163: 1711-1717
        • Siddique RM
        • Amini SB
        • Jr ConnorsAF
        • Rimm AA
        Race and sex differences in long-term survival rates for elderly patients with pulmonary embolism.
        Am J Public Health. 1998; 88: 1476-1480
        • Lilienfeld DE
        Decreasing mortality from pulmonary embolism in the United States, 1979–1996.
        Int J Epidemiol. 2000; 29: 465-469
        • Heit JA
        • Silverstein MD
        • Mohr DN
        • Petterson TM
        • O'Fallon WM
        • Melton 3rd LJ
        Predictors of survival after deep vein thrombosis and pulmonary embolism: a population-based, cohort study.
        Arch Intern Med. 1999; 159: 445-453
        • Nakamura M
        • Fujioka H
        • Yamada N
        • Sakuma M
        • Okada O
        • Nakanishi N
        • Miyahara Y
        • Kuriyama T
        • Kunieda T
        • Sugimoto T
        • Nakano T
        Clinical characteristics of acute pulmonary thromboembolism in Japan: results of a multicenter registry in the Japanese Society of Pulmonary Embolism Research.
        Clin Cardiol. 2001; 24: 132-138
        • Agarwal S
        • Clark 3rd D
        • Sud K
        • Jaber WA
        • Cho L
        • Menon V
        Gender disparities in outcomes and resource utilization for acute pulmonary embolism hospitalizations in the United States.
        Am J Cardiol. 2015; 116: 1270-1276
        • Blanco-Molina A
        • Enea I
        • Gadelha T
        • Tufano A
        • Bura-Riviere A
        • Di Micco P
        • Bounameaux H
        • González J
        • Villalta J
        • Monreal M
        • RIETE Investigators
        Sex differences in patients receiving anticoagulant therapy for venous thromboembolism.
        Medicine. 2014; 93: 309-317
        • Laporte S
        • Mismetti P
        • Décousus H
        • Uresandi F
        • Otero R
        • Lobo JL
        • Monreal M
        • RIETE Investigators
        Clinical predictors for fatal pulmonary embolism in 15,520 patients with venous thromboembolism: findings from the Registro Informatizado de la Enfermedad TromboEmbolica venosa (RIETE) Registry.
        Circulation. 2008; 117: 1711-1716
        • Lee CH
        • Cheng CL
        • Lin LJ
        • Tsai LM
        • Yang YH
        Epidemiology and predictors of short-term mortality in symptomatic venous thromboembolism.
        Circ J. 2011; 75: 1998-2004
        • White RH
        The epidemiology of venous thromboembolism.
        Circulation. 2003; 107: 14-18
        • Tanabe Y
        • Obayashi T
        • Yamamoto T
        • Takayama M
        • Nagao K
        Predictive value of biomarkers for the prognosis of acute pulmonary embolism in Japanese patients: results of the Tokyo CCU Network registry.
        J Cardiol. 2015; 66: 460-465
        • Loffredo L
        • Violi F
        • Perri L
        Sex related differences in patients with acute venous thromboembolism treated with new oral anticoagulants. A meta-analysis of the interventional trials.
        Int J Cardiol. 2016; 212: 255-258
        • Pancholy SB
        • Shantha GP
        • Patel T
        • Cheskin LJ
        Sex differences in short-term and long-term all-cause mortality among patients with ST-segment elevation myocardial infarction treated by primary percutaneous intervention: a meta-analysis.
        JAMA Intern Med. 2014; 174: 1822-1830
        • Towfighi A
        • Markovic D
        • Ovbiagele B
        Sex differences in revascularization interventions after acute ischemic stroke.
        J Stroke Cerebrovasc Dis. 2013; 22: e347-e353
        • Jenab Y
        • Ghaffari-Marandi N
        • Safir A
        • Ejmalian G
        • Zoroufian A
        • Jalali A
        • Sahebjam M
        Sex-related changes in tissue Doppler imaging parameters among patients with acute pulmonary thromboembolism.
        J Ultrasound Med. 2013; 32: 1997-2005
        • Tanabe N
        • Sugiura T
        • Tatsumi K
        Recent progress in the diagnosis and management of chronic thromboembolic pulmonary hypertension.
        Respir Investig. 2013; 51: 134-146