Nocturnal hypoxemia and prognosis in patients with acute symptomatic pulmonary embolism.

Data de publicació: 07/07/2023 Data Ahead of Print: 07/07/2023

Autors de IIS La Fe

María Cristina Rodríguez Varela

Autor
Miguel Ángel Martínez García

Autor

Autors aliens a IIS La Fe

Barbero, Esther
Manas, Eva
Retegui, Ana
Alberto-Garcia-Ortega
Garcia-Sanchez, Aldara
Cano-Pumarega, Irene
Jimenez, David

Grups d'Investigació

Endocrinología Reproductiva e Infertilidad

Leader

José Remohí Giménez
Neumología

Leader

Miguel Ángel Martínez García

Abstract

BACKGROUND: Nocturnal hypoxemia has been associated with cardiovascular and non-cardiovascular morbidity and mortality. This study aimed to investigate the prognostic value of nocturnal hypoxemia among patients with hemodynamically stable acute symptomatic pulmonary embolism (PE). METHODS: We performed an ad hoc secondary analysis of clinical data from a prospective cohort study. Nocturnal hypoxemia was measured by the percent sleep registry with oxygen saturation <90% [TSat90]). Outcomes assessed over the 30-days after the diagnosis of PE included PE-related death, other cardiovascular deaths, clinical deterioration requiring an escalation of treatment, recurrent venous thromboembolism (VTE), acute myocardial infarction [AMI], or stroke. RESULTS: Of the 221 hemodynamically stable patients with acute PE from which the TSat90 could be calculated and did not receive supplemental oxygen, the primary outcome occurred in 11 (5.0%; 95% confidence interval [CI], 2.5% to 8.7%) within 30-days after the diagnosis of PE. When categorized by quartiles, TSat90 was not significantly associated with the occurrence of the primary outcome in unadjusted Cox regression analysis (hazard ratio, 0.96; 95% CI, 0.57 to 1.63; P?=?0.88), or after adjustment for body mass index (adjusted hazard ratio, 0.97; 95% CI, 0.57 to 1.65; P?=?0.92). When examined as a completely continuous variable (between 0 and 100), TSat90 was not associated with a significant increase in the adjusted hazard of 30-day primary outcome rates (hazard ratio, 0.97; 95% CI, 0.86 to 1.10; P?=?0.66). CONCLUSIONS: In this study, nocturnal hypoxemia did not identify stable patients with acute symptomatic PE at increased risk for adverse cardiovascular events.