Pulmonary embolism (PE) and deep vein thrombosis (DVT) are two replicates of the same pathology, frequently associated. Isolated DVT has lower complication rates than PE. One third of clinically-overt DVTs are associated with a silent PE while the reported rates of concomitant DVT in PE are ranging from 10 to 93%. Whether the association of DVT and PE has a poorer prognosis than isolated PE is not known. Literature analysis shows conflicting data regarding the association of DVT and outcomes such as death and recurrence and the prognostic significance of coexisting deep vein thrombosis (DVT) in acute pulmonary embolism (PE) remains controversial.

This study aimed to provide routine patient care data on the impact of this association on PE severity and 3-month outcomes in a population presenting with symptomatic venous thromboembolism (VTE), from the REMOTEV registry.

REMOTEV is a prospective, non-interventional study of patients with acute symptomatic VTE, treated with direct oral anticoagulants (DOACs) or standard anticoagulation (vitamin K antagonists (VKA) or parenteral heparin/fondaparinux alone) for at least 3 months with a follow-up of 1 year for VTE recurrence, death and bleeding complications.

From November 1, 2013 to February 28, 2018, among 1241 consecutive patients included, 1192 had a follow-up of at least 3 months and, among them, 1037 had PE with (727) or without DVT (310). The median age was 69 (55–80, 25th–75th percentiles). Patients with PE-associated DVT had more severe forms of PE (P<0.0001). However, no significant difference in all-cause mortality rate [HR 1.36 (CI 95%: 0.69–2.92)], or in the composite criterion of all-cause mortality and recurrence rate [HR 1.56 (CI 95%: 0.83–3.10)] was noted at 3 months of follow-up.

In REMOTEV, coexisting DVT was associated with a higher severity of PE, with no impact on short-term prognosis (death and VTE recurrence).