In Suspected PE A-fib Doesn't Raise Odds of the Diagnosis
A-fib linked to decreased likelihood of pulmonary embolus when suspicion is based on new-onset dyspnea
WEDNESDAY, March 7 (HealthDay News) -- In general, the presence of atrial fibrillation (AF) does not increase the likelihood of pulmonary embolism (PE), according to a study published in the March issue of the Journal of Thrombosis and Haemostasis.
Gregoire Gex, of Geneva University Hospital, and associates retrospectively analyzed 2,449 patients admitted to the emergency department with suspected PE to investigate the association between AF and PE. Patients underwent electrocardiography, and PE was diagnosed by computed tomography.
The researchers found that the prevalence of PE was 22.8 percent in patients without AF and 18.8 percent in patients with AF (P = 0.28). AF did not significantly impact the probability of PE, after adjusting for confounding variables (odds ratio [OR], 0.68; 95 percent confidence interval [CI], 0.42 to 1.11). However, the presence of AF significantly reduced the probability of PE when suspicion of PE was due to new-onset dyspnea (OR, 0.47; 95 percent CI, 0.26 to 0.84); for patients presenting with isolated chest pain without dyspnea, AF was linked to increased probability of PE (OR, 2.42; 95 percent CI, 0.97 to 6.07).
"The presence of AF does not increase the probability of PE when this diagnosis is suspected," the authors write. "Nevertheless, when PE suspicion is based on new-onset dyspnea, AF significantly decreases the probability of PE, as AF may mimic its clinical presentation. However, in patients with chest pain alone, AF tends to increase PE probability."