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Asthma and the risk of pulmonary embolism

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Introduction: Chronic inflammatory diseases are associated with venous thromboembolism. In asthma, there is an imbalance of procoagulant and fibrinolytic mediators in the airways.

Objectives: Evaluate whether there is and increased risk of developing pulmonary embolism (PE) in asthmatic patients, and characterize the group of patients with asthma and PE.

Methods: Retrospective study of the patients admitted to the Pulmonology ward of a University Hospital in Lisbon, with the diagnosis of asthma and acute PE, during 2010-2014. Evaluation of all causes for acute PE. Characterization of asthmatic patients with PE: demographics; asthma control pre and post-anticoagulation; evaluation of thrombotic factors.

Read More : An observational study of physiotherapy for children with asthma

In 133 admissions for acute PE, 12% occurred in asthmatics, with 92% presenting as an exacerbation of the obstructive disease. Ninety two percent of the patients had uncontrolled asthma, although medicated according to steps 4 (62%) and 5 (23%) of the Global Initiative for Asthma (GINA) 2015. Twenty three percent needed chronic systemic corticosteroids. Forty percent had three or more admissions for asthma exacerbation. Two thirds of the asthmatic patients had one or more risk factors for PE.

There was a statistically significant association between the diagnosis of asthma and the development of PE (p-value=0,004). Asthmatic patients presented a 2,16 times higher odd of developing PE than non-asthmatic patients, for a confidence interval of 95% (1,256-3,705).

After beginning anticoagulation, 69% of patients achieved asthma control.

Conclusions: The diagnosis of PE should be considered in asthmatic patients, particularly those with severe or refractory asthma, poor disease control, and a higher number of exacerbations/hospital admissions.


Inês Barreto1, Catarina Teles Martins1, Alda Manique1 and Cristina Bárbara1
1Pulmonology, Centro Hospitalar Lisboa Norte - Hospital de Santa Maria, Lisbon, Portugal

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