Five-year followup of patients with pulmonary embolism in the Russian Sirena registry
E. A. Shmidt,
O. L. Barbarash,
S. A. Berns,
D. V. Duplyakov,
A. D. Erlich,
O. A. Lozhkina,
A. G. Neeshpapa https://doi.org/10.15829/1728-8800-2025-4419
EDN: WAMPFO
Abstract
Aim. To evaluate the results of a five-year follow-up of patients included in the Russian Registry of Acute Pulmonary Embolism (SIRENA), available to the contact at this stage of monitoring.
Material and methods. The SIRENA registry is a prospective, multicenter, observational cohort study designed to evaluate the treatment outcomes of patients with pulmonary embolism (PE) In Russian hospitals. The primary endpoints were all-cause death, recurrent PE, and major bleeding. Bleeding severity was defined according to the BARC (Bleeding Academic Research Consortium) criteria.
Results. A total of 283 patients aged 32 to 97 years (mean age 69 (59-76) years) were enrolled at nine centers; 135 of them were men (47,0%). Over 5 years of follow-up, 99 of 283 (34,9%) patients died. The most common causes of death were cancer (14,1%), death related to coronavirus disease 2019 (COVID-19) (17,2%), and recurrent PE (16,2%). During the first year of follow-up, cancer and recurrent PE were most frequent mortality causes, while deaths from COVID-19 and other cardiovascular diseases were more common during the 12-60-month follow-up period. Long-term anticoagulant therapy was continued by 29,7% of patients with PE at 60 months of follow-up, with 21 patients (7,4%) having bleeding episodes during this period. Most commonly, patients experienced one episode of BARC type 1 bleeding, but three patients experienced 10 or more bleeding episodes, which were considered minor.
Conclusion. Thus, this five-year study of patients with PE provides an assessment of their treatment outcomes 60 months after PE and may form the basis for future research on venous thromboembolism. High mortality rates, recurrent venous thromboembolism, and bleeding events within five years of follow-up after diagnosis of PE highlight the importance of effective treatment and accurate risk stratification for adverse outcomes.
About the Authors
E. A. Shmidt
Institute for Complex Issues of Cardiovascular Diseases
Russian Federation
Russian Federation
Academician Barbarash Boulevar 6, Kemerovo, 650002
O. L. Barbarash
Institute for Complex Issues of Cardiovascular Diseases
Russian Federation
Russian Federation
Academician Barbarash Boulevar 6, Kemerovo, 650002
S. A. Berns
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation
Russian Federation
Petroverigsky Lane, 10, bld. 3, Moscow, 101990,
D. V. Duplyakov
Samara State Medical University
Russian Federation
Russian Federation
Chapaevskaya Str. 89, Samara, 443099
A. D. Erlich
3Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
Ostrovityanova str., 1, Moscow, 117513
O. A. Lozhkina
Institute for Complex Issues of Cardiovascular Diseases
Russian Federation
Russian Federation
Academician Barbarash Boulevar 6, Kemerovo, 650002
A. G. Neeshpapa
Institute for Complex Issues of Cardiovascular Diseases
Russian Federation
Russian Federation
Academician Barbarash Boulevar 6, Kemerovo, 650002
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Supplementary files
What is already known about the subject?
- Studies show an annual increase in the incidence of pulmonary embolism (PE) with increasing life expectancy.
- Results from the global GARFIELD-VTE registry, published in 2023, showed a high mortality in patients with PE within 36 months of hospital discharge due to recurrent venous thromboembolism (VTE).
- The most common cause of death was recurrent PE following discontinuation of anticoagulant therapy.
What might this study add?
- Long-term 60-month follow-up of patients with PE identified a high-risk period for fatal recurrent PE — the first 12 months, during which secondary VTE prophylaxis with anticoagulant therapy should not be interrupted.
- The most common cause of death after the first year of follow-up was malignancy, along with recurrent PE.
- Prolonged anticoagulant therapy is received by ~30% of patients after PE, and during the 12-60 month follow-up period, deaths due to coronavirus disease 2019 and other cardiovascular diseases were more common.
- During the five-year follow-up period, a high incidence of non-severe bleeding (7,4%) was observed, with a single bleeding episode being the most common.
Review
For citations:
Shmidt E.A., Barbarash O.L., Berns S.A., Duplyakov D.V., Erlich A.D., Lozhkina O.A., Neeshpapa A.G. Five-year followup of patients with pulmonary embolism in the Russian Sirena registry. Cardiovascular Therapy and Prevention. 2025;24(9):4419. (In Russ.) https://doi.org/10.15829/1728-8800-2025-4419. EDN: WAMPFO
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