Syncope Paradox in the Outcome of Patients With Pulmonary Thromboembolism: Short-Term and Midterm Outcome Publisher Pubmed



Seyyedi SREZA¹ ; Jenab Y¹ ; Tokaldany ML¹ ; Shirani S¹ ; Sadeghian S¹ ; Jalali A¹ Show Affiliations
Source: Clinical Respiratory Journal Published:2016

Abstract

Background and Aim: We compare the early and midterm outcomes of pulmonary thromboembolism (PTE) in patients with and without syncope in our single-center registry. Method: Between December 2006 and May 2013, 351 consecutive patients (mean age=60.21±16.91 years, 55.3% male) with confirmed acute symptomatic PTE were divided in with and without syncope groups. Groups were compared in terms of the effect of syncope on 30-day mortality and adverse events, and mortality in a median follow-up time of 16.9 months. Results: From 351 patients, 39 (11.1%) had syncope and 312 (88.9%) did not. Syncope group had less frequently chest pain (30.8% vs 51.4%; P value=0.015). Also, the rates of 30-day adverse events and mortality were 12.8% and 5.1% for the group with syncope, and 14.4% and 10.3% for the group without syncope, respectively, with no significant difference. At follow up, 65 patients died and mortality was 18.5% for 351 patients (5.1% in the group with syncope and 20.2% for the other group). After adjustment for confounding factors, the effect of syncope on 30-day adverse events and mortality remained non-significant and on the midterm mortality was significant, showing that the presence of syncope was associated with lower midterm mortality (P value=0.038). Conclusion: Among PTE patients in our registry, 11.1% presented with syncope. Relationship between syncope and 30-day adverse events and mortality remained non-significant after adjustments for other factors. However, in midterm follow up, patients with syncope were significantly at decreased risk of mortality compared to those without syncope. © 2016 John Wiley & Sons Ltd.