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. 2019 Jun 23;8(6):899.
doi: 10.3390/jcm8060899.

Pulmonary Embolism and Coexisting Deep Vein Thrombosis: A Detrimental Association?

Elena-Mihaela Cordeanu  1   2 , Hélène Lambach  3 , Marie Heitz  4 , Julie Di Cesare  5 , Corina Mirea  6 , Alix-Marie Faller  7 , Anne-Cécile Cavaro  8 , Anne-Sophie Frantz  9 , Sebastien Gaertner  10 , Valérie Schini-Kerth  11 , Dominique Stephan  12   13
Affiliations

Pulmonary Embolism and Coexisting Deep Vein Thrombosis: A Detrimental Association?

Elena-Mihaela Cordeanu et al. J Clin Med. .

Abstract

Background: The prognostic significance of coexisting deep vein thrombosis (DVT) in acute pulmonary embolism (PE) is controversial. This study aimed to provide routine patient care data on the impact of this association on PE severity and 3-month outcomes in a population presenting with symptomatic venous thromboembolism (VTE) from the REMOTEV registry.

Methods and results: REMOTEV is a prospective, non-interventional study of patients with acute symptomatic VTE, treated with direct oral anticoagulants (DOACs) or standard anticoagulation (vitamin K antagonists (VKA) or parenteral heparin/fondaparinux alone) for at least 3 months. From 1 November 2013 to 28 February 2018, among 1241 consecutive patients included, 1192 had a follow-up of at least 3 months and, among them, 1037 had PE with (727) or without DVT (310). The median age was 69 (55-80, 25th-75th percentiles). Patients with PE-associated DVT had more severe forms of PE (p < 0.0001) and, when DVT was present, proximal location was significantly correlated to PE severity (p < 0.01). However, no difference in all-cause mortality rate (hazard ratio (HR) 1.36 (CI 95% 0.69-2.92)), nor in the composite criterion of all-cause mortality and recurrence rate (HR 1.56 (CI 95% 0.83-3.10)) was noted at 3 months of follow-up.

Conclusion: In REMOTEV, coexisting DVT was associated with a higher severity of PE, with no impact on short-term prognosis.

Keywords: deep vein thrombosis; pulmonary embolism; severity; venous thromboembolism.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study flowchart. DVT: deep vein thrombosis; PE: pulmonary embolism; VTE: venous thromboembolism. PE: pulmonary embolism; REMOTEV: Observational Prospective Monocentric Registry of Patients Suffering From Venous Thromboembolism.
Figure 2
Figure 2
Presence of coexisting deep vein thrombosis (%) according to pulmonary embolism severity. DVT: deep vein thrombosis. r: Pearson’s correlation coefficient.
Figure 3
Figure 3
Kaplan–Meier curves of (A) all-cause mortality, (B) the composite of venous thromboembolism recurrence and all-cause mortality, (C) the composite of major and non-major clinically relevant bleeding, venous thromboembolism recurrence, and all-cause death. CI: confidence interval; HR: hazard ratio; DVT: deep vein thrombosis; PE: pulmonary embolism.
Figure 3
Figure 3
Kaplan–Meier curves of (A) all-cause mortality, (B) the composite of venous thromboembolism recurrence and all-cause mortality, (C) the composite of major and non-major clinically relevant bleeding, venous thromboembolism recurrence, and all-cause death. CI: confidence interval; HR: hazard ratio; DVT: deep vein thrombosis; PE: pulmonary embolism.
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