[Pulmonary Embolism].

Area of Science:

• Cardiology
• Pulmonology
• Vascular Medicine

Background:

• Pulmonary embolism (PE) is a leading cardiovascular cause of death with increasing incidence.
• Patient risk for PE complications escalates with comorbidities and right ventricular dysfunction.
• Effective risk stratification is crucial for guiding PE treatment decisions.

Purpose of the Study:

• To outline the current understanding and management strategies for pulmonary embolism.
• To emphasize the importance of risk stratification in tailoring PE therapy.
• To discuss the role of anticoagulants and specialized teams in PE management.

Main Methods:

• Clinical, laboratory, and imaging parameters are used for PE risk stratification into four classes.
• Treatment decisions, especially for hemodynamically unstable patients, benefit from interdisciplinary Pulmonary Embolism Response Teams (PERT).
• Anticoagulant therapies, including NOACs and LMWHs, are evaluated for efficacy and safety.

Main Results:

• Risk stratification directly influences therapeutic choices, from outpatient management to reperfusion therapy.
• Non-vitamin K-dependent oral anticoagulants (NOACs) show comparable efficacy and a better safety profile than VKAs for PE.
• Low molecular weight heparins (LMWHs) are recommended for PE patients with cancer, with factor Xa-inhibitors showing promise.

Conclusions:

• PE risk stratification is essential for appropriate and effective treatment selection.
• NOACs are increasingly favored for anticoagulation in PE due to their safety and efficacy.
• Prolonged anticoagulation is vital for preventing venous thromboembolism recurrence, particularly in unprovoked events.