TCT-1042 Comparative Long-term Clinical Outcomes of Invasive Versus Noninvasive Treatments for Pulmonary Embolism in Women and Men: A Meta-Analysis and Review of the Literature

Document Type

Abstract

Publication Date

10-28-2025

Abstract

Background: Pulmonary embolism (PE) is a major cause of cardiovascular morbidity and mortality. The choice of treatment — invasive (thrombolytic therapy, percutaneous thrombectomy) or noninvasive (anticoagulation) — may influence outcomes, with sex-specific differences in response and complications. Methods: We performed a systematic review of the literature to compare long-term clinical outcomes following invasive and noninvasive treatments for PE in women and men. We extracted data from large registries, observational studies, and trial reports to compute odds ratios (OR), hazard ratios (HR), p-values, and 95% confidence intervals (CIs) for mortality, complications, and recurrence by sex and treatment. Results: Anticoagulation was associated with significantly lower 30-day (OR 0.81; p < 0.05) and 90-day (OR 0.83; p < 0.01) mortality in women, although major bleeding was higher (OR 1.31; p < 0.01) in comparison to men. Thrombolytic therapy provided a mortality benefit in men (p = 0.03) but not in women (p = 0.18), with women experiencing greater complications (RR 2.68; p = 0.005). Percutaneous thrombectomy was associated with higher procedural complications and in-hospital mortality in women (adjusted OR 1.9; p = 0.003) alongside a reduced likelihood of discharge to home (adjusted OR 0.7; p = 0.04). Women with high-risk PE who underwent advanced interventions had greater in-hospital mortality (adjusted OR 1.18; p < 0.001) than their male counterparts. Conclusion: Anticoagulation under standard care is generally more effective and safer in women with PE, while invasive strategies carry greater procedural complications and higher mortality. Our data highlight the necessity for sex-specific consideration and a tailored approach to PE treatment, especially in high-risk cases. Categories: ENDOVASCULAR: Pulmonary Embolism and Pulmonary Hypertension

Publication Title

Journal of the American College of Cardiology

Volume

86

Issue

17 Supplement

First Page

B444

Last Page

B445

Comments

Transcatheter Cardiovascular Therapeutics held 2025-10-25 to 2025-10-28 in San Francisco, CA

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