Clinical relevance of pulmonary infarction in patients with pulmonary embolism

Introduction: Data regarding the clinical relevance of pulmonary infarction (PI) in patients with pulmonary embolism (PE) are lacking. The aim of this study was to investigate the clinical features of PE patients with PI and the prognostic role of PI for PE patients. Materials and Methods: Based on computed tomography scan, 509 patients with PE were divided into two groups, the infarction group (n = 45) and the non-infarction group (n = 464). A variety of clinical parameters were compared between the two groups. Results: In the infarction group, the largest pulmonary arteries involved by emboli were central rather than peripheral and more proximal as compared to the non-infarction group (p = 0.01 and p<0.03, respectively). Thrombolytic agents tended to be more frequently administered in the infarction group (13.3% [n = 6] versus 6.3% [n = 29], p = 0.07). In-hospital mortality, PE-related deaths, and the recurrence rate of PE did not differ between the two groups. Conclusions: The present study did not demonstrate that PI is a prognostic indicator of recurrence and mortality in PE patients. We suggest the possibility that blood clot burden is greater in PE patients with PI, although PI by itself occurs in small pulmonary arteries. (c) 2012 Elsevier Ltd. All rights reserved.