Skip to main content
SpringerLink
Log in

Factors associating with the presence of residual thrombosis after 3-month treatment of acute pulmonary embolism

  • Published:
Journal of Thrombosis and Thrombolysis Aims and scope Submit manuscript

Abstract

The present study aimed to investigate the factors associating with the presence of residual thrombosis in patients with acute pulmonary embolism (APE) after at least 3-month anticoagulant therapy. Demographic and clinical data of 180 cases in the affiliated hospital of Qingdao University from January 2005 to June 2015 were retrospectively analyzed. APE in all patients were confirmed by computed tomography pulmonary angiography (CTPA). Patients were then detected for the presence of residual thrombosis according to a second CTPA. After appropriate comparison test, multivariate logistic regression analysis was performed to identify predictors for residual thrombosis. Among 180 patients, complete clearance of thrombosis occurred in 115 (63.9%) patients. Residual thrombosis remained in 65 (36.1%) patients. The independent factors associating with residual thrombosis include unprovoked APE (OR 0.231, 95% CI 0.062–0.861) and fibrinogen level in acute phase (OR 1.958, 95% CI 1.282–2.911). Furthermore, these two variables were both associated with the presence of residual thrombosis in patients receiving different parenteral anticoagulants (unfractionated heparin or low-molecular-weight heparin). Pulmonary thrombosis in some patients with APE are not completely dissolved after at least 3-month treatment. Additionally, unprovoked APE is positive predictor of decreased residual thrombosis and fibrinogen level in acute phase is a risk factor of the presence of residual thrombosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Torbicki A, Perrier A, Konstantinides S et al (2008) Guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 29:2276–2315

    Article  CAS  PubMed  Google Scholar 

  2. He JC, Xiansheng (2002) The epidemiology of pulmonary thromboembolism. Natl Med J China 82:1730–1731

    Google Scholar 

  3. Tapson VF (2008) Acute pulmonary embolism. N Engl J Med 358:1037–1052

    Article  CAS  PubMed  Google Scholar 

  4. Fiessinger JN, Huisman MV, Davidson BL et al (2005) Ximelagatran vs low-molecular-weight heparin and warfarin for the treatment of deep vein thrombosis: a randomized trial. JAMA 293:681–689

    Article  CAS  PubMed  Google Scholar 

  5. Meneveau N, Ider O, Seronde M-F, Chopard R, Davani S, Bernard Y, Schiele F (2013) Long-term prognostic value of residual pulmonary vascular obstruction at discharge in patients with intermediate-to high-risk pulmonary embolism. Eur Heart J 34:693–701

    Article  CAS  PubMed  Google Scholar 

  6. Agnelli G, Becattini C (2010) Acute pulmonary embolism. N Engl J Med 363:266–274

    Article  CAS  PubMed  Google Scholar 

  7. Klok FA, Zondag W, van Kralingen KW, van Dijk AP, Tamsma JT, Heyning FH, Vliegen HW, Huisman MV (2010) Patient outcomes after acute pulmonary embolism: a pooled survival analysis of different adverse events. Am J Respir Crit Care Med 181:501–506

    Article  PubMed  Google Scholar 

  8. Alonso-Martínez JL, Anniccherico-Sánchez FJ, Urbieta-Echezarreta MA, García-Sanchotena JL, Herrero HG (2012) Residual pulmonary thromboemboli after acute pulmonary embolism. Eur J Intern Med 23:379–383

    Article  PubMed  Google Scholar 

  9. Sanchez O, Helley D, Couchon S, Roux A, Delaval A, Trinquart L, Collignon MA, Fischer AM, Meyer G (2010) Perfusion defects after pulmonary embolism: risk factors and clinical significance. J Thromb Haemost 8:1248–1255

    Article  CAS  PubMed  Google Scholar 

  10. Authors/Task Force Members, Konstantinides SV, Torbicki A et al (2014) 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism: the task force for the diagnosis and management of acute pulmonary embolism of the european society of cardiology (ESC) endorsed by the european respiratory society (ERS). Eur Heart J 35:3033–3069

    Article  Google Scholar 

  11. Qanadli SD, El Hajjam M, Vieillard-Baron A et al (2001) New CT index to quantify arterial obstruction in pulmonary embolism: comparison with angiographic index and echocardiography. Am J Roentgenol 176:1415–1420

    Article  CAS  Google Scholar 

  12. Eichinger S, Heinze G, Jandeck LM, Kyrle PA (2010) Risk assessment of recurrence in patients with unprovoked deep vein thrombosis or pulmonary embolism. Circulation 121:1630–1636

    Article  PubMed  Google Scholar 

  13. Kim NH, Delcroix M, Jenkins DP et al (2013) Chronic thromboembolic pulmonary hypertension. J Am Coll Cardiol 62:D92–D99

    Article  PubMed  Google Scholar 

  14. Wartski M, Collignon M-A (2000) Incomplete recovery of lung perfusion after 3 months in patients with acute pulmonary embolism treated with antithrombotic agents. J Nucl Med 41:1043

    CAS  PubMed  Google Scholar 

  15. Aghayev A, Furlan A, Patil A, Gumus S, Jeon KN, Park B, Bae KT (2013) The rate of resolution of clot burden measured by pulmonary CT angiography in patients with acute pulmonary embolism. Am J Roentgenol 200:791–797

    Article  Google Scholar 

  16. den Exter PL, van Es J, Kroft LJ et al (2015) Thromboembolic resolution assessed by CT pulmonary angiography after treatment for acute pulmonary embolism. Thromb Haemost 114:26–34

    Article  Google Scholar 

  17. Zhai ZG, Wang J (2012) The pathogenesis of chronic thromboembolic pulmonary hypertension. Natl Med J China 92:1807–1809

    CAS  Google Scholar 

  18. Stein PD, Yaekoub AY, Matta F, Janjua M, Patel RM, Goodman LR, Gross ML, Denier JE (2010) Resolution of pulmonary embolism on CT pulmonary angiography. Am J Roentgenol 194:1263–1268

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Respiratory Medicine, The Affiliated Hospital of Qingdao University, Qingdao, 266100, China

    Jingluan Wang, Nina Sun & Zhaozhong Cheng

  2. Department of Respiratory Medicine, Central Hospital of ZiBo, Zibo, 255000, China

    Mingling Xu

  3. Department of Respiratory Medicine, Shengli Oilfield Central Hospital, Dongying, 257000, China

    Jingjing Sui

Authors
  1. Jingluan Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mingling Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nina Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zhaozhong Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jingjing Sui
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jingjing Sui.

Ethics declarations

Conflict of interest

All authors declare that they have no conflict of interest to state.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, J., Xu, M., Sun, N. et al. Factors associating with the presence of residual thrombosis after 3-month treatment of acute pulmonary embolism. J Thromb Thrombolysis 45, 27–35 (2018). https://doi.org/10.1007/s11239-017-1561-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11239-017-1561-6

Keywords

Search

Navigation