[Gender-specific differences in hemodynamically stable patients with acute pulmonary embolism].

BACKGROUND AND AIM: Pulmonary embolism (PE) is potentially life-threatening. Aim of this study was to identify genderspecific differences in acute PE and in risk stratification of hemodynamically stable PE patients.
METHODS: We analysed retrospectively the data of 129 patients with PE (59.7% women) and compared female and male patients regarding clinical, laboratory and technical parameters. ROC curve and Youden Index were calculated to analyse cardiac troponin I (cTnI) for predicting of right ventricular dysfunction (RVD) and D-Dimer for predicting submassive PE.
RESULTS: 129 patients were included in this study. Female patients were older (median 73.0 [25th percentile: 65.0/75th percentile: 81.0] vs. 65.5 [55.2/76.6] years, p = 0.0095) and had more frequent submassive PE (82.7% vs. 64.0%, p = 0.03) with higher systolic pulmonary artery pressure (38.00 ± 18.23 vs. 27.87 ± 17.32 mmHg, p = 0.0018). Multivariable regression analysis showed a strong association between cTnI and RVD (OR, 2.84; 95%CI: 1.52-5.32, p = 0.0011). Association between cTnI and RVD was stronger in male PE patients (OR, 27.67; 95%CI: 3.28-233.31, p = 0.0023) than in female (OR, 1.52; 95%CI: 0.79-2.93, p = 0.21). Area under the curve (AUC) for efficiency of cTnI predicting RVD was higher in male patients (0.92 vs. 0.69). AUC for efficiency of D-Dimer predicting submassive PE was similar in both genders (0.65 vs. 0.62). Genderspecific cTnI cut-off values indicating for RVD, were similar in male and female (> 0.00 vs. > 0.01 ng/ml). D-Dimer values above 1.08 mg/dl in male and 1.41 mg/dl in female indicated for submassive PE.
CONCLUSION: Normotensive female PE patients are in mean older and have more frequently submassive PE stadium. cTnI is associated with RVD. cTnI as risk stratification marker for predicting RVD is more effective in male. © Georg Thieme Verlag KG Stuttgart · New York.