Risk for Recurrent Venous Thromboembolism in Patients With Subsegmental Pulmonary Embolism Managed Without Anticoagulation
Authors: Lauren M. Westafer, David R. Vinson
Journal: Annals of Internal Medicine (2022)

LettersApril 2022Risk for Recurrent Venous Thromboembolism in Patients With Subsegmental Pulmonary Embolism Managed Without AnticoagulationLauren M. Westafer, DO, MPH, MS, David R. Vinson, MDLauren M. Westafer, DO, MPH, MSUniversity of Massachusetts Chan Medical School–Baystate, Amherst, Massachusetts, David R. Vinson, MDThe Permanente Medical Group and Kaiser Permanente Division of Research, Oakland, CaliforniaAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L22-0037 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR: Le Gal and colleagues' article (1) adds valuable information on the course of patients with symptomatic subsegmental pulmonary embolism (PE) who do not receive initial anticoagulation. In this study, structured follow-up revealed that 1.4% of patients with this condition who were initially managed without anticoagulation had progression of their PE within the first 90 days. Another 1.5% developed a proximal deep venous thrombosis. Because the CIs for venous thromboembolism (VTE) at 90 days crossed 3%, these results will undoubtedly push the needle toward recommending anticoagulation in all patients with symptomatic subsegmental PE. However, whether this study closes ...References1. Le Gal G, Kovacs MJ, Bertoletti L, et al; SSPE Investigators. Risk for recurrent venous thromboembolism in patients with subsegmental pulmonary embolism managed without anticoagulation. A multicenter prospective cohort study. Ann Intern Med. 2022;175:29-35. [PMID: 34807722] doi:10.7326/M21-2981 LinkGoogle Scholar2. Kline JA, Garrett JS, Sarmiento EJ, et al. Over-testing for suspected pulmonary embolism in American emergency departments: the continuing epidemic. Circ Cardiovasc Qual Outcomes. 2020;13:e005753. [PMID: 31957477] doi:10.1161/CIRCOUTCOMES.119.005753 CrossrefMedlineGoogle Scholar3. Germini F, Zarabi S, Eventov M, et al. Pulmonary embolism prevalence among emergency department cohorts: a systematic review and meta-analysis by country of study. J Thromb Haemost. 2021;19:173-85. [PMID: 33048461] doi:10.1111/jth.15124 CrossrefMedlineGoogle Scholar4. Hutchinson BD, Navin P, Marom EM, et al. Overdiagnosis of pulmonary embolism by pulmonary CT angiography. AJR Am J Roentgenol. 2015;205:271-7. [PMID: 26204274] doi:10.2214/AJR.14.13938 CrossrefMedlineGoogle Scholar5. Stevens SM, Woller SC, Baumann Kreuziger, et al. Executive summary: antithrombotic therapy for VTE disease: second update of the CHEST guideline and expert panel report. Chest. 2021;160:2247-59. [PMID: 34352279] doi:10.1016/j.chest.2021.07.056 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Massachusetts Chan Medical School–Baystate, Amherst, MassachusettsThe Permanente Medical Group and Kaiser Permanente Division of Research, Oakland, CaliforniaDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L22-0037. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRisk for Recurrent Venous Thromboembolism in Patients With Subsegmental Pulmonary Embolism Managed Without Anticoagulation Grégoire Le Gal , Michael J. Kovacs , Laurent Bertoletti , Francis Couturaud , Carole Dennie , Andrew M. Hirsch , Menno V. Huisman , Frederikus A. Klok , Noémie Kraaijpoel , Ranjeeta Mallick , Amanda Pecarskie , Elena Pena , Penny Phillips , Isabelle Pichon , Tim Ramsay , Marc Righini , Marc A. Rodger , Pierre-Marie Roy , Olivier Sanchez , Jeannot Schmidt , Sam Schulman , Sudeep Shivakumar , Albert Trinh-Duc , Rachel Verdet , Ulric Vinsonneau , Philip Wells , Cynthia Wu , Erik Yeo , Marc Carrier , and Risk for Recurrent Venous Thromboembolism in Patients With Subsegmental Pulmonary Embolism Managed Without Anticoagulation Marc Carrier and Grégoire Le Gal Metrics April 2022Volume 175, Issue 4Page: W43KeywordsDeep vein thrombosisHemorrhageHospital medicinePulmonary arteriesPulmonary embolismResearch fundingThrombosisUltrasound imagingVascular medicineVenous thromboembolism ePublished: 19 April 2022 Issue Published: April 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...