{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T03:53:31Z","timestamp":1775534011120,"version":"3.50.1"},"reference-count":24,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T00:00:00Z","timestamp":1604016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Diabetes mellitus (DM) predicts ominous outcomes in acute pulmonary embolism (PE). The influence of gender on the prognostic impact of DM in PE is unknown. We did a retrospective analysis of a cohort of patients hospitalized with PE between 2006 and 2013. The exclusion criteria were age &lt;18, non-pulmonary veins thromboembolism, recurrent PE, chronic thromboembolic pulmonary hypertension, no radiologic confirmation of PE, and active neoplasia. The primary endpoint was all-cause mortality. The follow-up was from diagnosis until October 2017. We assessed the prognostic impact of DM using a multivariate Cox regression analysis. The analysis was stratified according to gender. The interaction between gender and DM in the outcome of patients with PE was tested. We studied 577 PE patients (median age 65 years, 36.9% men, 19.8% diabetic). The genders were similar regarding the prevalence of DM, the extension and location of PE, and the thrombolytic therapy or brain natriuretic peptide (BNP) value. Diabetics presented higher all-cause mortality (Hazard ratio (HR) = 2.33 (95% confidence Interval (CI) 1.513.61)) when compared with non-diabetics. However, when analysis was stratified according to gender, DM was independently associated with a worse prognosis only in women (HR = 2.31 (95% CI 1.453.65)), while in men the HR was 1.10 (95% CI 0.592.04). The interaction between gender and DM was significant (p = 0.04). Gender influences the prognostic impact of DM in acute PE. Diabetic women with PE have twice the long-term mortality risk, while DM is not mortality-associated in men.<\/jats:p>","DOI":"10.3390\/jcm9113511","type":"journal-article","created":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T00:21:06Z","timestamp":1604017266000},"page":"3511","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Influence of Gender in The Prognostic Impact of Diabetes mellitus in acute Pulmonary Embolism"],"prefix":"10.3390","volume":"9","author":[{"given":"Diana","family":"Oliveira","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Medicina Interna do Centro Hospitalar e Universit\u00e1rio de S\u00e3o Jo\u00e3o, Alameda Prof Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"given":"Teresa","family":"Brito","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Medicina Interna do Centro Hospitalar e Universit\u00e1rio de S\u00e3o Jo\u00e3o, Alameda Prof Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7210-6854","authenticated-orcid":false,"given":"Catarina","family":"Elias","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Medicina Interna do Centro Hospitalar e Universit\u00e1rio de S\u00e3o Jo\u00e3o, Alameda Prof Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2019-0150","authenticated-orcid":false,"given":"Marta","family":"Carreira","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Medicina Interna do Centro Hospitalar e Universit\u00e1rio de S\u00e3o Jo\u00e3o, Alameda Prof Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"given":"Mariana","family":"Serino","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Pneumologia do Centro Hospitalar e Universit\u00e1rio de S\u00e3o Jo\u00e3o, Alameda Prof Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9295-7605","authenticated-orcid":false,"given":"In\u00eas","family":"Guerreiro","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Oncologia do Centro Hospitalar Universit\u00e1rio Lisboa Central, Alameda de Santo Ant\u00f3nio dos Capuchos, 1169\u2013050 Lisboa, Portugal"}]},{"given":"Helena","family":"Magalh\u00e3es","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Oncologia da Unidade de Sa\u00fade Local de Matosinhos, Rua Dr. Eduardo Torres, 4464-513 Matosinhos, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5111-5543","authenticated-orcid":false,"given":"Sara","family":"Coelho","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Oncologia do Instituto Portugu\u00eas de Oncologia do Porto Francisco Gentil, R. Dr. Ant\u00f3nio Bernardino de Almeida 62, 4200-072 Porto, Portugal"}]},{"given":"Sara","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Medicina Interna do Centro Hospitalar e Universit\u00e1rio de S\u00e3o Jo\u00e3o, Alameda Prof Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"given":"Emanuel","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Unidade de Cuidados Agudos Polivalente do Centro Hospitalar de Leiria, R. de Santo Andr\u00e9, 2410-197 Leiria, Portugal"}]},{"given":"Ana","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Medicina Interna do Centro Hospitalar e Universit\u00e1rio de S\u00e3o Jo\u00e3o, Alameda Prof Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"given":"Patr\u00edcia","family":"Louren\u00e7o","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Medicina Interna do Centro Hospitalar e Universit\u00e1rio de S\u00e3o Jo\u00e3o, Alameda Prof Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"},{"name":"Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,30]]},"reference":[{"key":"ref_1","first-page":"024935","article-title":"Association between diabetes mellitus and the risk for major cardiovascular outcomes and all-cause mortality in women compared with men: A meta-analysis of prospective cohort studies","volume":"9","author":"Wang","year":"2019","journal-title":"BMJ Open"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12916-019-1355-0","article-title":"Sex differences in the association between diabetes and risk of cardiovascular disease, cancer, and all-cause and cause-specific mortality: A systematic review and meta-analysis of 5,162,654 participants","volume":"17","author":"Wang","year":"2019","journal-title":"BMC Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1186\/s12992-018-0437-7","article-title":"Sex differences and risk factors for diabetes mellitus\u2014An international study from 193 countries","volume":"14","author":"Elling","year":"2018","journal-title":"Glob. 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