Patients with diabetes mellitus (DM) suffer from hypercoagulable state which may increase their risk for thromboembolism. However, the data about this association is contradictory in the literature. The goal of this study was to evaluate the occurrence of pulmonary embolism and pulmonary hypertension (HTN) in patients with DM after adjusting for coronary artery disease (CAD), congestive heart failure (CHF), hypertension and smoking using a large database.
We used patient treatment files (PTF) to document inpatients’ admissions containing discharge diagnoses (ICD-9 codes) from all Veterans Health Administration Hospitals. The patients were divided in two groups: ICD-9 code for DM (293,124) and a control group with ICD-code for hypertension (HTN) but no DM (552,623). ICD-9 codes for pulmonary embolism (415.19) and ICD-9 code for pulmonary hypertension (416.0) were used to study prevalence of these diseases in DM patients vs the control. We performed uni- and multi-variant analysis adjusting for CAD, CHF and smoking. Continuous variables and binary variables were analyzed using X2 and Fisher’s Exact tests.
Pulmonary embolism was present in 2011 (0.7%) vs 2759 (0.5% ) in the control group. Pulmonary hypertension was present in 3356 (1.1%) vs 3357 (0.6%) in the control group. Using multivariate analysis, DM remained independently associated with pulmonary embolism (OR: 1.27; CI: 1.19 to 1.35; p<0.000) and with pulmonary hypertension (OR: 1.53; CI: 1.45 to 1.60; p<0.000).
Patients with DM have significantly higher prevalence of pulmonary embolism and pulmonary hypertension independent of CAD, HTN, CHF or smoking.
This finding could partially explain the higher risk of sudden death in diabetes patients in addition to other cardiovascular abnormalities. We suggest that the clinician should be more aware of this risk that could be potentially treated and life saving.
Mohammad-Reza Movahed, None.