title: Comparison of clinical and imaging characteristics and outcomes between provoked and unprovoked acute pulmonary embolism in Koreans.
abstract: This study was performed to compare clinical and imaging parameters and prognosis of unprovoked pulmonary embolism (PE), provoked PE with reversible risk factors (provoked-rRF), and provoked PE with irreversible risk factors (provoked-iRF) in Koreans. Three hundred consecutive patients (mean age, 63.6 ± 15.0 yr; 42.8% male) diagnosed with acute PE were included. The patients were classified into 3 groups; unprovoked PE, provoked-rRF, and provoked-iRF; 43.7%, 14.7%, and 41.7%, respectively. We followed up the patients for 25.4 ± 33.7 months. Composite endpoint was all-cause mortality and recurrent PE. The provoked-iRF group had significantly higher all-cause mortality, mortality from PE and recurrent PE than the unprovoked and provoked-rRF groups (P < 0.001, P < 0.001, and P = 0.034, respectively). Prognostic factors of composite endpoint in the unprovoked group were high creatinine (> 1.2 mg/dL; P < 0.001; hazard ratio [HR], 4.735; 95% confidence interval [CI], 1.845-12.152), C-reactive protein (CRP; > 5 mg/L; P = 0.002; HR, 5.308; 95% CI, 1.824-15.447) and computed tomography (CT) obstruction index (P = 0.034; HR, 1.090; 95% CI, 1.006-1.181). In conclusion, provoked-iRF has a poorer prognosis than unprovoked PE and provoked-rRF. Renal insufficiency, high CRP, and CT obstruction index are poor prognostic factors in unprovoked PE.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors.forename: Jae-Sun
authors.initials: JS
authors.lastname: Uhm
authors.forename: Hae-Ok
authors.initials: HO
authors.lastname: Jung
authors.forename: Chan-Joon
authors.initials: CJ
authors.lastname: Kim
authors.forename: Tae-Hoon
authors.initials: TH
authors.lastname: Kim
authors.forename: Ho-Joong
authors.initials: HJ
authors.lastname: Youn
authors.forename: Sang Hong
authors.initials: SH
authors.lastname: Baek
authors.forename: Wook-Sung
authors.initials: WS
authors.lastname: Chung
authors.forename: Ki Bae
authors.initials: KB
authors.lastname: Seung
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D002097:C-Reactive Protein / Q000032:analysis; D003404:Creatinine / Q000097:blood; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000401:mortality; D012008:Recurrence; D051437:Renal Insufficiency / Q000150:complications; D056910:Republic of Korea; D012307:Risk Factors; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
chemical_list: D002097:C-Reactive Protein; D003404:Creatinine