Cancer as a risk factor for residual pulmonary embolism.

Aim: Despite anticoagulation in some patients after pulmonary embolism (PE) pulmonary emboli are not completely resolved. The goal of our prospective study was to evaluate the rate of residual pulmonary emboli in repeated CT pulmoangiography 13-17 weeks after setting the diagnosis of PE and to determine the relationship between primary risk factors for PE, the results of the primary entry tests and the incidence of residual pulmonary embolism.

Methods: Fifty-three patients aged 59.8 (54.9-67.7) years with confirmed first episode of PE were enrolled into the study, 37 patients after appropriate anticoagulation underwent the repeated CT pulmoangiography.

Results: This examination confirmed the presence of embolic residues in pulmonary arteries in 8 patients (21.6%). After analyzing the observed entry (by admission to the hospital with the diagnosis of PE) parameters (age, sex, systolic and diastolic blood pressure, heart rate, waist circumference, body weight, body mass index, presence of hypertension, diabetes mellitus type 2, the presence of inflammatory disease, immobilization, recent surgery or overcome trauma, history of malignancy, venous thromboembolism in the past, previous treatment with statins, CRP, troponin T, TSH, D-dimer, total cholesterol, LDL cholesterol, HDL cholesterol, serum trigylcerides) the authors note that the only parameter that was significantly associated with persisting embolic residues was malignancy (2/29 patients without residues vs. 4/8 patients with residues, odds ratio=13.5, 95%CI=1.8344-99.35, P=0.0106). There was no statistically significant difference in other observed parameters.

Conclusion: Malingnancy represents an important predictor of incomplete recanalization of pulmonary arteries after the first episode of pulmonary embolism.