Thrombosis Research Group, EA3065, University Saint-Etienne, Jean Monnet, Saint-Etienne F-42023, France.
Respir Res. 2013 Jul 18;14(1):75. doi: 10.1186/1465-9921-14-75.
Patients with chronic obstructive pulmonary disease (COPD) have a modified clinical presentation of venous thromboembolism (VTE) but also a worse prognosis than non-COPD patients with VTE. As it may induce therapeutic modifications, we evaluated the influence of the initial VTE presentation on the 3-month outcomes in COPD patients.
COPD patients included in the on-going world-wide RIETE Registry were studied. The rate of pulmonary embolism (PE), major bleeding and death during the first 3 months in COPD patients were compared according to their initial clinical presentation (acute PE or deep vein thrombosis (DVT)).
Of the 4036 COPD patients included, 2452 (61%; 95% CI: 59.2-62.3) initially presented with PE. PE as the first VTE recurrence occurred in 116 patients, major bleeding in 101 patients and mortality in 443 patients (Fatal PE: first cause of death). Multivariate analysis confirmed that presenting with PE was associated with higher risk of VTE recurrence as PE (OR, 2.04; 95% CI: 1.11-3.72) and higher risk of fatal PE (OR, 7.77; 95% CI: 2.92-15.7).
COPD patients presenting with PE have an increased risk for PE recurrences and fatal PE compared with those presenting with DVT alone. More efficient therapy is needed in this subtype of patients.
慢性阻塞性肺疾病（COPD）患者的静脉血栓栓塞症（VTE）临床表现有所改变，但与非 COPD 合并 VTE 患者相比，预后更差。因为 VTE 的初始表现可能会引起治疗上的改变，所以我们评估了 COPD 患者 VTE 的初始表现对 3 个月结局的影响。
研究了正在进行的全球 RIETE 注册研究中的 COPD 患者。根据初始临床表现（急性 PE 或深静脉血栓形成（DVT））比较 COPD 患者在 3 个月内的肺栓塞（PE）、大出血和死亡率的发生率。
在纳入的 4036 例 COPD 患者中，2452 例（61%；95%CI：59.2-62.3）最初表现为 PE。116 例患者发生首次 VTE 复发，101 例患者发生大出血，443 例患者死亡（致命性 PE：首要死因）。多变量分析证实，表现为 PE 与更高的 VTE 复发风险相关（PE：OR，2.04；95%CI：1.11-3.72）和更高的致命性 PE 风险（OR，7.77；95%CI：2.92-15.7）。
与仅表现为 DVT 的患者相比，表现为 PE 的 COPD 患者发生 PE 复发和致命性 PE 的风险增加。这类患者需要更有效的治疗。
