RT journal article
T1 Characteristics and outcomes of acute pulmonary embolism among patients with polyvascular, single-vascular or no atherosclerotic disease: insights from RIETE
A1 Cardi, Silvia
A1 Barco, Stefano
A1 Wolf, Simon
A1 Demelo‑Rodríguez, Pablo
A1 Pérez‑Pinar, Montserrat
A1 Skride, Andris
A1 Tazi‑Mezalek, Zoubida
A1 López Sáez, José Juan Bosco
A1 Marchena, Pablo Javier
A1 Monreal, Manuel
A2 Cirugía
A2 Medicina
K1 Pulmonary embolism
K1 Venous thromboembolism
K1 Atherosclerosis
K1 Cardiovascular disease
K1 Platelet aggregation inhibitors
K1 Registries retrospective studies
AB Background The role of atherosclerosis in pulmonary embolism (PE) prognosis remains uncertain. Our study assessescharacteristics and outcomes of acute PE patients according to the presence and extent of atherosclerotic disease.Methods Using data from the RIETE registry, acute PE patients were classified into three groups based on personal history: (1) polyvascular atherosclerosis, (2) single vascular atherosclerosis, and (3) no symptomatic atherosclerosis. Primaryoutcomes included recurrent PE and venous thromboembolism (VTE), arterial events, major bleeding, and all-cause death.Hazard ratios (HR) and Kaplan–Meier curves for clinical outcomes were estimated using Cox regression models.Results Among 47,578 acute PE patients, 1,040 had polyvascular, 6,191 single-vascular, and 40,347 no atherosclerosis.During a median follow-up of 331 days, Adverse outcomes were more frequent in patients with atherosclerosis (vs. noatherosclerosis), rising with the number of affected vascular territories. Recurrent PE rates were 2.8, 1.6, and 1.2 per 100patient-years in the polyvascular, single-vascular, and no atherosclerosis groups. Multivariable analysis showed a dosedependent relationship between atherosclerosis and recurrent PE risk, with HRs of 3.2 (95% CI 1.7–5.9) and 1.6 (95% CI1.1–2.3) for polyvascular and single-vascular disease (vs. no atherosclerosis). The risk of all-cause death followed a similartrend, with HRs of 1.3 (95% CI 1.1–1.6) and 1.2 (95% CI 1.1–1.4), respectively. Major bleeding appeared to be influencedby overall health status and antithrombotic therapy intensity.Conclusion Atherosclerosis in acute PE patients may serve as a marker of disease severity and lead independently to adverseoutcomes, highlighting the importance of cardiovascular risk stratification
PB Springer
SN 1861-0692
YR 2025
FD 2025-06-30
LK http://hdl.handle.net/10498/38172
UL http://hdl.handle.net/10498/38172
LA eng
DS Repositorio Institucional de la Universidad de Cádiz
RD 10-may-2026