Introduction: T he importance of gender differences in acute pulmonary embolism (APE) patients remains controversial and unclear.
Objective: We aimed to examine the sex related diffe-rences in characteristics and short term outcome in pa-tients with APE.
Methods: We analyzed in a prospective manner a group of 120 patients diagnosed with APE with contrast tho-racic CT scan which were admitted successively in the Cardiology Department of „Sfântul Pantelimon” Hos-pital Bucharest between January 2014 and March 2019. The patients were monitored using clinical and para-clinical data throughout their entire hospitalization period.
Results: The analyzed population (n =120) had an ave-rage age of 68.3 ± 12.5 years, of which the percentage of female patients was 63.3%. In-hospital mortality, re-gardless of sex, was 15%. Taking into account the risk factors for APE, prolonged immobilization was identi-fied as being more frequent in female patients (OR=3; 95%CI: 1.0523-8.7442, p=0.05). Female patients in our group were older, but without statistical significance (69.1 years vs. 66.9 years, p=0.3). Regarding the onset symptoms, the patients did not differ significantly in case of: syncope, dyspnea, chest pain, shock or cardio-respiratory arrest. There were no significant differences between the two groups in regard to the presentation as massive APE and neither in the PESI score. From a biological point of view, female patients had a higher NT-proBNP versus male patients (8416 pg/ml vs. 3756 pg/ml, p=0.04). On the ECG female patients had more frequent new right bundle branch block (OR=3.1; 95%CI: 1.3-7.1, p =0.008). When the set of patients was evaluated by cardiac ultrasound, males had a larger ri-ght ventricle (36 mm vs 33.2 mm, p =0.04) and a shor-ter PAT (79.4 msec vs. 99 msec, p=0.009). There were no differences in in-hospital mortality, even when we analyzed the normotensive patients.
Conclusions: T his study showed that female patients and APE had a short-term mortality rate comparable to that of male patients without indicating the need for significant differences in therapy. We recommend taking into account the possible increased risk of ble-eding associated with female sex, documented in lite-rature.