title: The influence of acute pulmonary embolism on early and delayed prognosis for patients with chronic heart failure.
abstract: BACKGROUND
  Patients with acute pulmonary embolism (APE) with concomitant chronic heart failure (CHF) are characterized by higher mortality rates than APE patients without CHF. The aim of this study is to evaluate the potential impact of APE on early and long-term prognosis in patients with CHF.
  
  
  METHODS
  This study included 87 patients with CHF with suspected APE. Patients were divided into two groups according to spiral computed tomography results: one group with confirmed APE and one with excluded APE. Total and cardiovascular mortality in patients of both groups during a 6- and 36-month follow up period was assessed. Potential risk factors for mortality in patients with CHF in short and long-term observations were identified.
  
  
  RESULTS
  APE was diagnosed in 35 patients, and excluded in the remaining 52 patients. Total and cardiovascular 6-month mortality was higher in APE patients than in patients without APE: 34.3% and 28.5% vs. 13.4% and 11.5%, p = 0.02, p = 0.02, respectively. In 6-month follow-up the only independent risk factor for mortality was the presence of APE (HR = 2.7, 95% CI 1.1-24.4, p = 0.04). However, in the 36-month follow-up APE had no effect on mortality.
  
  
  CONCLUSIONS
  Patients with CHF and acute episode of PE are characterized by a higher 6-month total and cardiovascular mortality rate following discharge from hospital compared to patients hospitalized due to acute CHF decompensation. Moreover, recent episode of PE in patients with CHF is an independent risk factor for early mortality in a 6-month follow-up.
authors.affiliation: Department of Internal Medicine, University of Varmia and Masuria, Olsztyn, Poland. lgol@op.pl
authors.forename: Leszek
authors.initials: L
authors.lastname: Gromadziński
authors.forename: Ryszard
authors.initials: R
authors.lastname: Targoński
authors.forename: Beata
authors.initials: B
authors.lastname: Januszko-Giergielewicz
authors.forename: Michał
authors.initials: M
authors.lastname: Ciurzyński
authors.forename: Piotr
authors.initials: P
authors.lastname: Pruszczyk
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D042241:Early Diagnosis; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000401:mortality; D006801:Humans; D007297:Inpatients; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D015912:Thrombolytic Therapy / Q000379:methods; D013997:Time Factors; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome