Acute Pulmonary Embolism in Women: Focus on Estrogen Therapy as a Predisposing Factor

Hassan Aghajani; Mahboobeh Aghajani; Saeed Ghodsi; Yaser Jenab; Azita  Hajhossein Talasaz; Amine Ghram; Saeed Tofighi

doi:10.18502/acta.v59i6.6894

Hassan Aghajani Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
Mahboobeh Aghajani Department of Cardiology, Tehran Heart Center Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
Saeed Ghodsi Department of Cardiology, Tehran Heart Center Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
Yaser Jenab Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
Azita Hajhossein Talasaz Department of Clinical Pharmacy, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
Amine Ghram Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
Saeed Tofighi Department of Cardiology, Tehran Heart Center Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/acta.v59i6.6894

Keywords: Pulmonary embolism; Estrogen; Mortality; Women; Thromboembolism; Deep vein thrombosis

Abstract

Acute pulmonary embolism (APE) is a potentially fatal disorder. The literature shows that estrogen therapy is correlated with an increase in mortality and morbidity. Accordingly, the purpose of the present study was to investigate the prevalence and prognostic significance of the recent history of estrogen therapy in women with APE. This study was conducted on female patients admitted to our hospital between January 2008 and January 2016. A total of 276 patients (mean age=62.66±08 y) with confirmed APE were divided into groups with and without recent estrogen therapy. The relationships between estrogen and clinical findings, risk factors, imaging findings, and in-hospital mortality were analyzed. Among the 276 women with APE at presentation, 37 (13.4%) patients had a recent history of estrogen therapy. The estrogen group had a lower frequency of hypertension (21.6% vs49.8%; P< .001), immobilization of at least 3 days (16.2% vs 33.5%; P= .035), and pleural effusion (0% vs16.7%; P= .007) than the group without recent estrogen use. Among the 276 patients, the rate of 1 year’s mortality was 15.8% for the group without recent estrogen therapy. No death occurred in the estrogen group. Older age, tachycardia, tachypnea, malignancy, and lack of obesity were the predictors of 1 year’s mortality. Among the patients with APE in our study, 13.4% had a history of recent estrogen therapy. No death occurred during the 1-year follow-up of these patients.