Outcomes of fibrinolytic therapy for patients with metastatic cancer and acute pulmonary embolism

Gbolahan O. Ogunbayo, Robert Pecha, Naoki Misumida, Elliott Goodwin, Karam Ayoub, Dustin Hillerson, Ayman Elbadawi, Ahmed Abdel-latif, Claude S. Elayi, Adrian W. Messerli, Susan S. Smyth

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Introduction: Malignancy is a common cause of morbidity and mortality in the United States and around the world and the second leading cause of death in the United States. There is little data on the impact of metastatic cancer on the risk of hemorrhagic stroke or mortality among patients undergoing fibrinolytic therapy (FT) for acute PE. Methods: Using the National Inpatient Sample (NIS) database, we extracted admissions with a primary diagnosis of acute pulmonary embolism that underwent FT from 2010 to 2014. We performed a case control matched analysis between patients with and without metastatic cancer. Our primary outcome of interest was Mortality and our secondary outcome of interest was hemorrhagic stroke (HS). Results: Of the 883,183 patients with a primary diagnosis of acute PE between 2010 and 12014, 23,690 patients (2.7%) underwent FT. After exclusion, 22,592 patients were included in the analysis. Of these, 941 patients (4.2%) were reported to have metastatic cancer. There was a higher incidence of cerebrovascular accidents and intubation/mechanical ventilation in the metastatic cancer arm. Mortality was significantly higher in the metastatic cancer arm with no difference in the incidence of HS. In multivariate regression analysis, among all patients that underwent FT for acute PE, metastatic cancer was associated with a significant odds for mortality (OR 1.91, 95% CI 1.11–5.82, p <.001). Conclusion: The presence of metastatic cancer in patients undergoing fibrinolytic therapy for acute pulmonary embolism is associated with increase mortality.

Original languageEnglish
Pages (from-to)104-107
Number of pages4
JournalPulmonary Pharmacology and Therapeutics
StatePublished - Jun 2019

Bibliographical note

Publisher Copyright:
© 2019


  • Acute pulmonary embolism
  • Fibrinolytic therapy (FT)
  • Metastatic cancer
  • Mortality

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Biochemistry, medical
  • Pharmacology (medical)


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