Reperfusion in high-risk acute pulmonary embolism: can the PESI score predict outcomes?

Abstract Introduction Acute pulmonary embolism (PE) is one of the leading causes cardiovascular death worldwide. Haemodynamic (HD) instability defines high risk (HR) early mortality and reperfusion treatment standard care for rapid relieve right ventricle (RV) overload in these situations. The impact long-term outcomes not well established. PE Severity Index (PESI) score used to stratify HD stable patients (pts) was validated predict HR-PE. Purpose Estimate prognostic performance PESI HR-PE study its possible interaction acute pts. Methods Retrospective single-centre consecutive pts, defined by 2019 ESC guidelines criteria, between 2008–2018. Logistic regression analysis performed test an tertiles early-mortality (during hospitalization at 30 days) as 1-year MACE (a composite mortality, recurrence or chronic thromboembolic hypertension). Results Of a total 1955 102 fulfilled inclusion criteria (72.5% pts initially presented with remaining developing after hospital admission). Mean age 68±15 years 60% were females. In-hospital 30-day 39.6% 43.0%, respectively. At one-year follow-up, 55.0%. time diagnosis 200±39 showed significant differences in-hospital (189±38 vs 217±34; OR 1.02, 95% CI 1.00–1.03, p<0.001), (191±38 214±36; p=0.004) 1y-MACE (186±41 214±32; 1.01–1.03, p<0.001). Total rate 57.8% also associated lower (OR 0.45, 0.20–1.02; p=0.057), 0.35, 0.15–0.80; p=0.012) p=0.014). benefit significantly influenced categorized (figure 1). Conclusions Although stratifies this population it able Furthermore, late outcomes. FUNDunding Acknowledgement Type funding sources: None. Figure 1. Interaction