Abstract 14049: Correlation of Cellular Indices and D-dimer/fibrinogen Ratio to Gender Differences in 6-minute Walk Test Distance in Patients Presenting With Acute Pulmonary Embolism

Abstract

Introduction: The six-minute walk test (6MWT) is a simple and well-validated test to assess functional status and predict morbidity and mortality in several chronic cardiopulmonary disease states. Neutrophil to Lymphocyte ratio (NLR) reflects a pro inflammatory state. Increased platelet to lymphocyte ratio (PLR) has been associated with increase in thrombus burden. Elevated D-dimer to fibrinogen ratio (D/f) reflects fibrinolysis activation. No study has investigated the correlation of these indices with gender differences in 6MWT in patients presenting with pulmonary embolism (PE). Methods: We retrospectively evaluated all acute PE patients from our Pulmonary Embolism Response Team Registry who completed a 6MWT during their initial hospitalization. Differential complete blood count data along with d-dimer and fibrinogen were collected within 24 hours prior to PE diagnosis. Results: A total of 186 patients underwent baseline 6MWT and lab tests between March 2016 and January 2020. The mean walking distance for males (765 ft) was further than females (519 ft; figure 1). NLR, PLR, and D/f did not correlate with 6MWT in males. In females, NLR, PLR, and D/f had a negative correlation with walking distance (r = -0.20, p <0.05; r = -3.0, p<0.01; and r = -0.15, p<0.05; figure 2) Conclusions: Female patients, in our study, had significantly shorter walking distance after acute presentation in PE. This may reflect higher inflammatory and prothrombotic state. Future studies will need to expand on these findings.