Association of Serum Cholesterol Levels with Short-term Mortality in Patients with Acute Pulmonary Embolism

Background Serum cholesterols play an important role in pathophysiology and prognosis of acute thrombotic diseases. The aim of the present study was to investigate the prognostic value of serum lipid parameters in acute pulmonary embolism (APE). Methods From January 2008 to January 2014 a total of 275 patients who were hospitalised with a diagnosis of APE were retrospectively screened. Clinical data, laboratory parameters, serum cholesterol levels were recorded and pulmonary embolism severity index (PESI) scores were calculated. Mortality rate at 30 days was investigated as the clinical outcome. Results In our study population, 24 patients (8.7%) died within 30 days. Serum total cholesterol, LDL-C, HDL-C and triglyceride levels were significantly lower in deceased patients when compared to the survived patients (3.1 +/- 0.6 vs. 4.7 +/- 1.2 mmol/L, p < 0.01; 1.8 +/- 0.9 vs. 2.9 +/- 0.9 mmol/L, p < 0.01; 0.9 +/- 0.3 vs. 1.2 +/- 0.3 mmol/L, p < 0.01; 1.4 +/- 0.7 vs. 1.7 +/- 0.6 mmol/L, p = 0.04, respectively). In multivariate regression analysis; PESI scores (OR: 1.06 95% CI: 1.01-1.11, p < 0.01), right ventricular diameter (OR: 11.31 95% CI: 3.25-52.64, p < 0.01), total cholesterol (OR: 1.09 95% CI: 1.02-1.17, p < 0.01), LDL-C (OR: 1.06 95% CI: 1.01-1.12, p = 0.02), HDL-C (OR: 1.21 95% CI: 1.04-1.41, p < 0.01) and triglyceride (OR: 1.03 95% CI: 1.01-1.05, p < 0.01) levels were independently correlated with mortality. Conclusions Serum total cholesterol, LDL-C, HDL-C and triglyceride levels, obtained within the first 24 hours of hospital admission, may have prognostic value in patients with APE.