부산대학교 도서관

Background: Acute pulmonary embolism (APE) is the third leading cause of cardiovascular death following stroke and myocardial infarction. Data regarding the impact of sex differences on the presentation, management, and outcomes of patients with (APE) remains limited. This study aimed to identify baseline characteristics and treatment strategies in males (M) versus females (F) from a single center experience.Methods: We retrospectively analyzed patients who underwent evaluation by our institutional pulmonary embolism response team for APE between 3/1/2016 and 1/1/2022. Baseline characteristics, biomarkers, and outcomes of interest were compared using Pearson’s Chi-squared test for categorical variables and Wilcoxon rank sum test for continuous variables.Results: The cohort included 886 patients, of whom 48.6% were females. The mean age was (61 ± 16) years. Males were more likely to be smokers (41% vs. 26 %; p<0.001), have a lower Body Mass Index (BMI) (31 ± 9 kg/m, vs 33 ±10; p=0.01) and were more likely to have a history of prior stroke (12% vs 7.9%; p=0.04). The mean brain natriuretic peptide (BNP) on presentation was significantly higher in females (361 ± 624 pg/ml vs 281 ± 505; p=0.019). The mean d-dimer (F: 7,041 ± 6,438 ng/ml vs M: 9,063 ±11,447; p=0.13), troponin I (F: 1.60 ± 15.58 ng/ml vs M: 0.72±4.11; p=0.3), and lactic acid (F: 2.58 ± 3.20 mm/l vs M: 2.42 ± 2.43; p=0.6) were similar between both groups. PE severity (massive: 5.3% vs 6.4%; submissive: 58% vs: 55%; P=0.8) was similar between females and males. There were also no sex-based differences in the use of advanced therapies or outcomes. (Figure 1)Conclusion: In our APE cohort from a single center tertiary care center, sex differences in comorbidity profile (BMI, tobacco use, history of stroke) were observed. Females had a significantly higher BNP consistent with prior published literature. However, there were no sex-based disparities in PE severity, management, escalation of advanced therapies or outcomes.