{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T02:18:10Z","timestamp":1790561890118,"version":"4.1.0"},"reference-count":27,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T00:00:00Z","timestamp":1732579200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100005292","name":"Brigham and Women\u2019s Hospital","doi-asserted-by":"publisher","award":["IGNITE Award and Mary Ann Tynan Award to Dr. Bikde"],"award-info":[{"award-number":["IGNITE Award and Mary Ann Tynan Award to Dr. Bikde"]}],"id":[{"id":"10.13039\/100005292","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vasc Med"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>\n                      Sex differences exist in risk factors and comorbidities of older adults (aged \u2a7e 65 years) with pulmonary embolism (PE). Clinically relevant sex-based treatment disparities for PE have not been adequately addressed. The few existing show conflicting results due to small sample size (type II error) and suboptimal methods (overreliance on\n                      <jats:italic>p<\/jats:italic>\n                      -value, which may detect differences of small clinical relevance).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We assessed sex differences in anticoagulation and advanced therapies for PE in older adults, utilizing data from Registro Informatizado Enfermedad TromboEmbolica (RIETE), a large PE registry with predominant participation from Europe, and data from US Medicare beneficiaries. We prespecified a standardized difference (SRD) &gt; 10% as clinically relevant. RIETE included 33,462 (57.7% female) and Medicare included 102,391 (55.0% female) older adults with PE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In RIETE, there were no overall sex differences in the use of anticoagulation (median: 181 vs 180 days, SRD &lt; 1%), fibrinolysis (SRD &lt; 3%), thrombectomy (SRD &lt; 2%), or inferior vena cava (IVC) filters (SRD: 4.4%). However, fibrinolytic therapy (systemic or catheter-based) was less often used in female than male patients with intermediate-risk PE (8.0% vs 12.1%, SRD: 13.6%). No sex differences were noted with advanced PE therapies in Medicare beneficiaries. In unadjusted analyses, fibrinolysis and IVC filter placement were more frequent in Medicare than RIETE participants regardless of sex (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In a predominantly European PE registry and a US study of older adults, there were no overall sex differences in anticoagulation patterns or advanced therapy utilization. Future studies should determine if sex disparities in fibrinolytic therapy for intermediate-risk PE and greater use of advanced therapies in US older adults correlate with clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1358863x241292023","type":"journal-article","created":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T04:24:15Z","timestamp":1732595055000},"page":"58-66","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Sex differences in treatment strategies for pulmonary embolism in older adults: The SERIOUS-PE study of RIETE participants and US Medicare beneficiaries"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1428-879X","authenticated-orcid":false,"given":"Behnood","family":"Bikdeli","sequence":"first","affiliation":[{"name":"Cardiovascular Medicine Division, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"},{"name":"Thrombosis Research Group, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"},{"name":"YNHH\/Yale Center for Outcomes Research and Evaluation (CORE), New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5489-6987","authenticated-orcid":false,"given":"Hannah","family":"Leyva","sequence":"additional","affiliation":[{"name":"Cardiovascular Medicine Division, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"},{"name":"Thrombosis Research Group, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfonso","family":"Muriel","sequence":"additional","affiliation":[{"name":"Respiratory Department, Hospital Ram\u00f3n y Cajal and Medicine Department, Universidad de Alcal\u00e1 (Instituto de Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria), Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Respiratorias, Madrid, Spain"},{"name":"Clinical Biostatistics Unit, Hospital Universitario Ram\u00f3n y Cajal, IRYCIS, CIBERESP: Universidad de Alcal\u00e1, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenqiu","family":"Lin","sequence":"additional","affiliation":[{"name":"YNHH\/Yale Center for Outcomes Research and Evaluation (CORE), New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Piazza","sequence":"additional","affiliation":[{"name":"Cardiovascular Medicine Division, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"},{"name":"Thrombosis Research Group, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candrika D","family":"Khairani","sequence":"additional","affiliation":[{"name":"Thrombosis Research Group, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel P","family":"Rosovsky","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology\/Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghazaleh","family":"Mehdipour","sequence":"additional","affiliation":[{"name":"Department of Radiology, Division of Nuclear Medicine, Montefiore Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle L","family":"O\u2019Donoghue","sequence":"additional","affiliation":[{"name":"Cardiovascular Medicine Division, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"},{"name":"TIMI Study Group, Brigham and Women\u2019s Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Madridano","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario Infanta Sof\u00eda, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Bosco","family":"Lopez-Saez","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario de Puerto Real, C\u00e1diz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meritxell","family":"Mellado","sequence":"additional","affiliation":[{"name":"Department of Angiology and Vascular Surgery, Hospital del Mar, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Maria","family":"Diaz Brasero","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario de Guadalajara, Guadalajara, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elvira","family":"Grandone","sequence":"additional","affiliation":[{"name":"Thrombosis and Haemostasis Unit, Fondazione I.R.C.C.S. \"Casa Sollievo della Sofferenza\", San Giovanni Rotondo, Foggia, Italy"},{"name":"Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, Foggia, Italy"},{"name":"Department of Obstetrics, Gynecology and Perinatal Medicine, First Sechenov University, Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Primavera A","family":"Spagnolo","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Mary Horrigan Connors Center for Women\u2019s Health &amp; Gender Biology, Brigham and Women Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Lu","sequence":"additional","affiliation":[{"name":"YNHH\/Yale Center for Outcomes Research and Evaluation (CORE), New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Bertoletti","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Vasculaire et Th\u00e9rapeutique, CHU de Saint-Etienne, Saint-Etienne, France"},{"name":"INSERM, UMR1059, Equipe Dysfonction Vasculaire et H\u00e9mostase, Universit\u00e9 Jean-Monnet, Saint-Etienne, France"},{"name":"INSERM, CIC-1408, CHU de Saint-Etienne, Saint-Etienne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciano","family":"L\u00f3pez-Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Provincial Reina Sof\u00eda, C\u00f3rdoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Jes\u00fas N\u00fa\u00f1ez","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Complejo Hospitalario de Pontevedra, Pontevedra, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1ngeles","family":"Blanco-Molina","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario Reina Sof\u00eda, C\u00f3rdoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Gerhard-Herman","sequence":"additional","affiliation":[{"name":"Cardiovascular Medicine Division, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel Z","family":"Goldhaber","sequence":"additional","affiliation":[{"name":"Cardiovascular Medicine Division, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"},{"name":"Thrombosis Research Group, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon M","family":"Bates","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology and Thromboembolism, McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Jimenez","sequence":"additional","affiliation":[{"name":"Respiratory Department, Hospital Ram\u00f3n y Cajal and Medicine Department, Universidad de Alcal\u00e1 (Instituto de Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria), Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Respiratorias, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harlan M","family":"Krumholz","sequence":"additional","affiliation":[{"name":"YNHH\/Yale Center for Outcomes Research and Evaluation (CORE), New Haven, CT, USA"},{"name":"Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA"},{"name":"Department of Internal Medicine, Section of Cardiovascular Medicine, Yale 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Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism. Exp Clin Cardiol 2013; 18: 129\u2013138.","journal-title":"Exp Clin Cardiol"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1160\/TH17-07-0511"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000000114"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2022.106714"},{"key":"e_1_3_3_11_2","article-title":"Crucial considerations: Sex differences in the epidemiology, diagnosis, treatment, and outcomes of acute pulmonary embolism in non-pregnant adult patients","volume":"2","author":"Jarman AF","year":"2021","unstructured":"Jarman AF, Mumma BE, Singh KS, et al. Crucial considerations: Sex differences in the epidemiology, diagnosis, treatment, and outcomes of acute pulmonary embolism in non-pregnant adult patients. 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