title: Prevalence of heart diseases in patients with pulmonary embolism with and without peripheral venous thrombosis: findings from a cross-sectional survey.
abstract: BACKGROUND
  In up to 80% of patients with pulmonary embolism (PE) no peripheral symptomatic thrombosis can be identified. Whether the heart may represent a source of PE is unknown.
  
  
  METHODS
  We conducted a cross-sectional survey of patients who were 60 years or older and were discharged from the hospitals of Veneto region, Italy between 2000 and 2006 with the diagnosis of PE. We compared the prevalence of several acute and chronic heart diseases in patients discharged with the diagnosis of PE alone with that of patients with co-occurring symptomatic peripheral deep venous thrombosis (PE/DVT).
  
  
  RESULTS
  Out of 11,236 eligible patients, 9079 (81%) were discharged with the diagnosis of PE alone, and 2157 with that of PE/DVT. 3239 of the 9079 (35.7%) patients with isolated PE, and 666 of the 2157 (30.9%) with PE/DVT had at least one heart disease. The adjusted odds ratio (OR) for having at least one heart disease in patients with isolated PE as compared to those with PE/DVT was 1.26 (95% CI, 1.13-1.40). The heart diseases that significantly contributed to the study results were all-cause cardiomyopathies (adjusted OR, 2.31; 95% CI, 1.37-3.89), all-cause heart failure (1.82; 1.45-2.27), coronary heart disease (1.28; 1.08-1.52), and atrial fibrillation or flutter (1.28; 1.08-1.51).
  
  
  CONCLUSIONS
  There is an association between isolated PE and a number of heart diseases. The results of our survey generate the hypothesis that in older patients several heart diseases may directly account for the development of PE. Prospective studies are needed to confirm this hypothesis.
authors.affiliation: Department of Cardiothoracic and Vascular Sciences, University of Padua, Italy. paoloprandoni@tin.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Prandoni
authors.forename: Raffaele
authors.initials: R
authors.lastname: Pesavento
authors.forename: Henrik T
authors.initials: HT
authors.lastname: Sørensen
authors.forename: Nicola
authors.initials: N
authors.lastname: Gennaro
authors.forename: Fabio
authors.initials: F
authors.lastname: Dalla Valle
authors.forename: Isabella
authors.initials: I
authors.lastname: Minotto
authors.forename: Fabio
authors.initials: F
authors.lastname: Perina
authors.forename: Vittorio
authors.initials: V
authors.lastname: Pengo
authors.forename: Antonio
authors.initials: A
authors.lastname: Pagnan
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006331:Heart Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D006760:Hospitalization; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011655:Pulmonary Embolism / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D012307:Risk Factors; D020246:Venous Thrombosis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy