To the best of our knowledge, in a retrospective cohort study of 252 consecutively confirmed acute pulmonary embolism patients treated with tissue plasminogen activator (t-PA), patients in the high BUN group (≥34.5 mg/dL) had a higher incidence of CS, and elevated admission BUN levels were independently related with a high risk of in-hospital mortality [13]. Here, PLAT is linked to Cowden syndrome 1.