title: Pulmonary embolism and 3-month outcomes in 4036 patients with venous thromboembolism and chronic obstructive pulmonary disease: data from the RIETE registry.
abstract: BACKGROUND
  Patients with chronic obstructive pulmonary disease (COPD) have a modified clinical presentation of venous thromboembolism (VTE) but also a worse prognosis than non-COPD patients with VTE. As it may induce therapeutic modifications, we evaluated the influence of the initial VTE presentation on the 3-month outcomes in COPD patients.
  
  
  METHODS
  COPD patients included in the on-going world-wide RIETE Registry were studied. The rate of pulmonary embolism (PE), major bleeding and death during the first 3 months in COPD patients were compared according to their initial clinical presentation (acute PE or deep vein thrombosis (DVT)).
  
  
  RESULTS
  Of the 4036 COPD patients included, 2452 (61%; 95% CI: 59.2-62.3) initially presented with PE. PE as the first VTE recurrence occurred in 116 patients, major bleeding in 101 patients and mortality in 443 patients (Fatal PE: first cause of death). Multivariate analysis confirmed that presenting with PE was associated with higher risk of VTE recurrence as PE (OR, 2.04; 95% CI: 1.11-3.72) and higher risk of fatal PE (OR, 7.77; 95% CI: 2.92-15.7).
  
  
  CONCLUSIONS
  COPD patients presenting with PE have an increased risk for PE recurrences and fatal PE compared with those presenting with DVT alone. More efficient therapy is needed in this subtype of patients.
authors.affiliation: Thrombosis Research Group, EA3065, University Saint-Etienne, Jean Monnet, Saint-Etienne F-42023, France. laurent.bertoletti@gmail.com
authors.forename: Laurent
authors.initials: L
authors.lastname: Bertoletti
authors.forename: Sara
authors.initials: S
authors.lastname: Quenet
authors.forename: Silvy
authors.initials: S
authors.lastname: Laporte
authors.forename: Joan Carles
authors.initials: JC
authors.lastname: Sahuquillo
authors.forename: Francisco
authors.initials: F
authors.lastname: Conget
authors.forename: José María
authors.initials: JM
authors.lastname: Pedrajas
authors.forename: Mar
authors.initials: M
authors.lastname: Martin
authors.forename: Ignacio
authors.initials: I
authors.lastname: Casado
authors.forename: Antonio
authors.initials: A
authors.lastname: Riera-Mestre
authors.forename: Manuel
authors.initials: M
authors.lastname: Monreal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D038622:Internationality; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality*; D011655:Pulmonary Embolism / Q000401:mortality*; D012042:Registries; D018570:Risk Assessment; D016019:Survival Analysis; D015996:Survival Rate; D054556:Venous Thromboembolism / Q000401:mortality*; D055815:Young Adult