Women presenting with pulmonary embolism (PE) and fibroids are younger and are more likely to be Black patients, use hormones, and have iliac vein compression compared with women presenting with PE and gynecologic cancer. These findings were presented at the Transcatheter Cardiovascular Therapeutics (TCT) Scientific Symposium 2022 held from September 17th through 19th, in Boston, Massachusetts.
Medical records of patients (N=718) presenting with PE between 2018 and 2022 at Columbia University Irving Medical Center in New York were retrospectively reviewed. Patients who were found to have uterine fibroids (n=18) and active ovarian, uterine, cervical, or vulvar cancers (n=20) were evaluated for characteristics and outcomes up to 1 year.
The fibroid and cancer cohorts were aged mean 52.6±7.8 and 62.5±11.4 years (P <.01), 50.0% and 14.3% were Black individuals (P =.04), and 83.3% and 80.0% presented with dyspnea (P =1.00), respectively.
It was more common for the fibroid cohort to use hormones (38.9%; P <.01), to have iliac vein compression (27.8%; P =.02), and to have a recent trauma event or surgical intervention (27.8%; P =.02) compared with no such events among the gynecologic cancer cohort. In addition, more patients with fibroids received invasive PE therapy (94.4%) compared with the gynecologic malignancy group (40.0%; P <.01).
Both cohorts had similar deep vein thrombosis, intensive care unit admission, and 1-year mortality rates.
The major limitation of this study is the small sample size. Additional study is needed to more robustly understand the relationship between PE and fibroids or gynecologic malignancy in order to better inform clinical decision making.
The study authors concluded that patients presenting with PE and fibroids were younger and more likely to be Black and to receive advanced therapeutic interventions compared with patients presenting with PE and gynecologic malignancy. “Additional work is needed to understand which patients are most at risk for PE in these populations to improve clinical diagnosis and decision making,” the study authors wrote.
Sethi S, Gockley A, Parikh S, et al. Characteristics and outcomes of patients with fibroids and gynecologic malignancies presenting with pulmonary emboli. Presented at: The Transcatheter Cardiovascular Therapeutics Scientific Symposium; September 17-19, 2022; Boston, MA. Abstract #230.