Abstract 13452: Sex Differences in Presentation, Management, and Outcomes Among Patients Hospitalized With Acute Pulmonary Embolism

• Published in: Circulation (New York, N.Y.) Vol. 142; no. Suppl_3 Suppl 3; p. A13452
• Main Authors: Pribish, Abby M, Beyer, Sebastian, Krawisz, Anna K, Weinberg, Ido, Carroll, Brett J, Secemsky, Eric A
• Format: Journal Article
• Language: English
• Published: by the American College of Cardiology Foundation and the American Heart Association, Inc 17-11-2020
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.142.suppl_3.13452

IntroductionThe presence of gender disparities in cardiovascular disease has been well-described, but there is a paucity of data regarding the impact of gender on the presentation, management and outcomes of acute pulmonary embolism (PE). HypothesisWe hypothesized that there are no gender-based differences in PE management or outcomes. MethodsWe identified all patients admitted to our institution with acute PE from 8/1/2012-7/1/2018. We stratified presenting characteristics, management and outcomes between women and men. Outcomes included major bleeding, survival, 90-day readmission, and 90-day recurrent venous thromboembolism (VTE). Inverse probability of treatment weighting was used to evaluate the independent association between sex and in-hospital and short-term outcomes. ResultsThe study included 2031 patients with PE, 53.2% of whom were women. Women had a higher mean age (63.8 years vs 62.3 years, P=0.04). PE severity was similar between women and men (massive4.9% vs 3.6%; submassive43.9% vs 41.8%; P=0.19), but women were more likely to present with dyspnea (59.8% vs 52.0%, P<0.001) and had higher median NT-pro-BNP levels (605 pg/mL [IQR 143-2582] vs 319 pg/mL [IQR 82-1576], P<0.001). Although the comorbidity burden was similar, women were less likely to have a history of PE (19.3% vs 24.2%, P=0.01), smoking (43.1% vs 53.3%, P<0.001), or myocardial infarction (6.6% vs 9.7%, P=0.01). In unadjusted analyses, women were less likely to survive to discharge (92.4% vs 94.7%, P=0.04), but after adjustment, there was no gender-based survival difference. There were also no gender differences in PE-related diagnostic studies, use of advanced therapies, or other short-term outcomes, before and after adjustment (p>0.05 for all) (Fig 1). ConclusionsIn this large PE cohort from a tertiary care institution, women had different comorbidity profiles and PE presentations than men. Despite this, there were no gender disparities in PE management or outcomes.