Prospective cohort study restricted to patients with low-risk subsegmental pulmonary embolism managed without anticoagulation
TUESDAY, Nov. 23, 2021 (HealthDay News) — The rate of recurrent venous thromboembolism is higher than expected for patients with subsegmental pulmonary embolism managed without anticoagulation who do not have proximal deep venous thrombosis, according to a study published online Nov. 23 in the Annals of Internal Medicine.
Gr ©goire Le Gal, M.D., Ph.D., from the Centre Hospitalier R ©gional et Universitaire de Brest in France, and colleagues examined the rate of recurrent venous thromboembolism in patients with subsegmental pulmonary embolism managed without anticoagulation in a prospective cohort study conducted at 18 sites between February 2011 and February 2021. Patients underwent bilateral lower-extremity venous ultrasonography at diagnosis; if results were negative, it was repeated one week later. Anticoagulant therapy was not given to patients without deep vein thrombosis.
After the predefined stopping rule was met when 292 of a projected 300 patients were enrolled, recruitment was stopped prematurely. The researchers found that the primary outcome of recurrent venous thromboembolism during the 90-day follow-up period occurred in eight of 266 patients included in the primary analysis, for a cumulative incidence of 3.1 percent. For patients with single and multiple isolated subsegmental pulmonary embolism, the incidence of recurrent venous thromboembolism was 2.1 and 5.7 percent, respectively, during the 90-day follow-up. None of the patients had a fatal recurrent pulmonary embolism.
“Our study can inform patients and clinicians about the risks of managing isolated subsegmental pulmonary embolism without anticoagulation,” the authors write.
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