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Impact of advanced age on the severity of normotensive pulmonary embolism

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Abstract

The prevalence of pulmonary embolism (PE) increases progressively with age. Less data about the impact of increasing age on the severity of PE are available. The objectives of this study were to investigate the impact of increasing age on the severity of normotensive PE. Retrospective analysis of clinical, laboratory, radiological and echocardiagraphic data of normotensive patients with PE was performed. According to patients’ age at the moment of acute PE event, the total number of 129 normotensive PE patients was subdivided into 4 age groups. In age groups 18–59, 60–69, 70–79 and 80–94 years were, respectively, a number of 30, 31, 33 and 35 patients included. Percentage of women in age groups increased with advanced age (P = 0.021). Systolic pulmonary artery pressure (PAP) (P < 0.0001) and frequency of incomplete or complete right bundle-branch block (RBBB) (P = 0.019), of right ventricular dysfunction (RVD) (P = 0.00031) and of submassive PE stadium with intermediate risk (P = 0.0016) increased significantly with growing age. Multivariable regression model confirmed an association between age and submassive PE [OR (per year) 1.04; 95 % CI, 1.02–1.07, P = 0.0020] as well as female gender and submassive PE (OR 2.45; 95 % CI, 1.10–5.50, P = 0.029) and tachycardia and submassive PE (OR 15.33; 95 % CI, 3.45–68.24, P = 0.00034). Advanced age, female gender and tachycardia are risk factors for a submassive PE with intermediate risk in normotensive PE patients. The percentage of PE patients with submassive PE, right ventricular overload, RVD, RBBB, elevated systolic PAP increases with advanced age.

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Abbreviations

AHA:

American heart association

CT:

Computed tomography

cTn:

Cardiac troponin

cTnI:

Cardiac troponin I

DVT:

Deep vein thrombosis

ECG:

Electrocardiography

ESC:

European society of cardiology

PE:

Pulmonary embolism

RBBB:

Right bundle-branch block

RVD:

Right ventricular dysfunction

SD:

Standard deviation

PAP:

Systolic pulmonary artery pressure

PESI:

Pulmonary embolism severity index

V/Q scan:

Ventilation–perfusion scan

VTE:

Venous thromboembolism

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Authors and Affiliations

  1. Department of Medicine II, University Medical Center Mainz, Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany

    Karsten Keller & Meike Coldewey

  2. Centrum for Thrombosis and Haemostasis, University Medical Center Mainz, Johannes Gutenberg-University Mainz, Mainz, Germany

    Karsten Keller & Meike Coldewey

  3. Department of Internal Medicine, St. Vincenz and Elisabeth Hospital Mainz (KKM), Mainz, Germany

    Johannes Beule & Wolfgang Dippold

  4. Department of Radiology and Nuclear Medicine, Catholic Clinic Mainz (KKM), Mainz, Germany

    Jörn Oliver Balzer

  5. Department of Diagnostic and Interventional Radiology, University Clinic, Johann Wolfgang Goethe-University, Frankfurt, Germany

    Jörn Oliver Balzer

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  1. Karsten Keller
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  2. Johannes Beule
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Keller, K., Beule, J., Coldewey, M. et al. Impact of advanced age on the severity of normotensive pulmonary embolism. Heart Vessels 30, 647–656 (2015). https://doi.org/10.1007/s00380-014-0533-4

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