Mireuță Aurelia-Maria

Medic Rezident Cardiologie, anul II

 Introduction
COPD-4th cause of morbidity; 5th cause of
mortality (according to WHO)
COPD systemic inflammation prone to
pulmonary embolism (PE)

Retrospective cohort
study
12 out of 10000/year COPD
patients  PE (x4 > non-
COPD) with higher prevalence
among acute exacerbations
Epidemiology
Significantly higher prevalence
in:
The higher the degree of airway
• Whites and African obstruction – the higher the risk
Americans of venous thrombembolism
(VTE)
• Hospitalized patients
 Risk factors

• Age , ♀
• Hypertension
• Hipoxaemia (PaO2<40 mmHg) & invasive mechanical ventilation
• Signs & symptoms sugestive of DVT
• Peripheral vascular disease
• Policitemia – independent risk factor
• ↑PDW
 Pathophisiology

Systemic inflammation
IL-6, TNF-α, GDF-15

Oxidative stress, endothelial dysfunction,

hypoxemia
Eosinophilia

Hypercoagulability
 Clinical features

Patients with AECOPD & PE have more

chest pain and fewer symptoms of
respiratory tract infection than those
without PE

VTE is more common in hospitalized

patients with AECOPD with history of
varicose veins in lower limbs extremities
& longer immobilization time >3 days
Diagnosis
 Prognosis

Different studies have shown:

-the hospitalization rate and 30-day mortality rate where higher in COPD complicated with VTE than in those
without VTE

-COPD patients at 3 months of follow-up had significantly minor bleeding, first recurrence of VTE or higher
mortality than those without COPD

-compared with DVT, PE occurred more frequently in COPD patients

-AECOPD & PE  higher average length of hospitalization and in-hospital mortality

- ~50% of COPD patients with acute PE, most of whom where at low risk, continued to have dyspnea, movement
restriction and other sequelae within 1 year after the disease.
 Conclusion

PE

• more likely to be misdiagnosed or ignored

• independent risk factor for poor prognosis in patients with acute

exacerbation of COPD

• preventable with early anticoagulant treatment in AECOPD.