Pulmonary vascular disease & thromboembolism
Long-Term Outcomes Following Catheter-Based Therapies in Older Adults With Acute Pulmonary Embolism
Authors' conclusion
Among older adults with high-risk or intermediate-risk PE, patients treated with CBT experienced lower mortality over the follow-up of up to 3 years, but higher risk of in-hospital bleeding complications.
Study context
- Population
- Medicare fee-for-service beneficiaries aged 65 to 99 years admitted for high- or intermediate-risk pulmonary embolism (PE), 2017 to 20206,742 high-risk
- Exposure
- CBT vs no CBT
- Outcome
- Long-term mortality
- Follow-up
- Up to 3 years
Methodological detailspropensity score matching weight, instrumental variable analysis
- Propensity score matching weight
- Instrumental variable analysis
Main finding
As reported in the abstract
3-year mortality
CBT
- High-risk PE
- 45.7%
- Intermediate-risk PE
- 14.9%
No CBT
- High-risk PE
- 65.5%
- Intermediate-risk PE
- 30.3%
High-risk PE
CBT45.7%
No CBT65.5%
Intermediate-risk PE
CBT14.9%
No CBT30.3%
CBT vs No CBTAdjusted hazard ratio (95% CI)
High-risk PE
0.76(0.67–0.85)
Intermediate-risk PE
0.69(0.63–0.75)
Observational data: associations, not effects.
Further findings
| Outcome | CBT | No CBT | aOR (95% CI) | |
|---|---|---|---|---|
| In-hospital deathHigh-risk PE | 0.73 (0.61–0.87) | |||
| High-risk PE | 29.0% | 43.9% | ||
| Intermediate-risk PE | 3.1% | 4.1% | ||
| In-hospital deathIntermediate-risk PE; no evidence of difference | 0.93 (0.75–1.16) | |||
| 0.512Adjusted odds ratio (log scale) |
Safety
| Outcome | CBT | No CBT | aOR (95% CI) | |
|---|---|---|---|---|
| Intracranial hemorrhageHigh-risk PE | 2.29 (1.18–4.44) | |||
| High-risk PE | 2.1% | 1.0% | ||
| Intermediate-risk PE | 0.5% | 0.3% | ||
| Intracranial hemorrhageIntermediate-risk PE | 2.04 (1.17–3.55) | |||
| 0.20.5125Adjusted odds ratio (log scale) |
Original publication
Long-Term Outcomes Following Catheter-Based Therapies in Older Adults With Acute Pulmonary Embolism. JACC Adv. Published 28 May 2025. doi:10.
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