Gonda Vascular Center, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Curr Cardiol Rep. 2024 Nov;26(11):1249-1264. doi: 10.1007/s11886-024-02128-0. Epub 2024 Aug 31.
Pulmonary embolism (PE) is the third most common cause of cardiovascular morbidity and mortality. The goal of this review is to discuss the most up-to-date literature on epidemiology, diagnosis, risk stratification, and management of acute PE.
Despite an increase in annual incidence rate of PE in the United States and development of multiple advanced therapies for treatment of acute PE, PE-related mortality is not consistently decreasing across populations. Although multiple risk stratification schemes have been developed, it is still unclear which advanced therapy should be used for the individual patient and optimal timing. Fortunately, multiple randomized clinical trials are underway to answer these questions. Nevertheless, up to 50% of patients have persistent reduced quality of life 6 months after acute PE, termed post-PE syndrome. Despite advances in therapeutic options for management of acute PE, many questions remain unanswered, including optimal risk stratification and management of acute PE.
肺栓塞(PE)是心血管发病率和死亡率的第三大常见原因。本文的目的是讨论关于急性 PE 的流行病学、诊断、风险分层和管理的最新文献。
尽管美国 PE 的年发生率有所增加,并且有多种治疗急性 PE 的先进疗法,但人群中 PE 相关死亡率并没有持续下降。尽管已经制定了多种风险分层方案,但对于个体患者,仍不清楚应该使用哪种先进疗法,以及最佳时机是什么。幸运的是,正在进行多项随机临床试验来解答这些问题。尽管如此,仍有多达 50%的患者在急性 PE 后 6 个月仍存在持续的生活质量下降,称为 PE 后综合征。尽管在急性 PE 的治疗选择方面取得了进展,但仍有许多问题尚未得到解答,包括急性 PE 的最佳风险分层和管理。