The following is a summary of “Heart failure alters diagnostic yield for pulmonary embolism in patients undergoing computed tomography pulmonary angiogram,” published in the February 2023 issue of Emergency Medicine by Kewcharoen, et al.

The impact of a history of heart failure (HF) on the effectiveness of the assessment of pulmonary embolism (PE) in the Emergency Department (ED) was not well supported by the available research.

The Loma Linda University Medical Center’s ED analyzed the electronic medical records of all people who received a computed tomography pulmonary angiogram (CTPA) consecutively between June 1, 2019, and March 25, 2022. Exclusion criteria were patients with isolated right ventricular HF or repeat examinations on the same patient without a clear HF diagnosis. Researchers gathered important demographic data, test results, vital signs, and information on pertinent drugs. The incidence of PE on CTPA was the primary outcome and was compared between individuals with and without pre-existing HF.

The research comprised 2,846 patients altogether (602 patients with HF and 2,244 without). PE was discovered on CTPA in 11.7% (n = 334) of the patients in the entire cohort. Individuals with a history of HF had a lower incidence of PE on CTPA (12.5% vs. 9%) than patients without a history of HF. In multivariable analysis, a history of pre-existing HF was linked to a decreased odds ratio for a positive PE study (OR 0.13, 95%CI: 0.03-0.57).

In the study, they found that patients who received CTPA had a lower incidence of PE than individuals who did not have pre-existing heart failure (HF). If HF was a significant mitigating factor for risk-stratifying patients for PE, more research was needed to ascertain this.

Reference: sciencedirect.com/science/article/pii/S073567572200701X