TY - JOUR
T1 - Active search for chronic thromboembolic pulmonary hypertension does not appear indicated after acute pulmonary embolism
AU - Surie, Sulaiman
AU - Gibson, Nadine S.
AU - Gerdes, Victor E. A.
AU - Bouma, Berto J.
AU - van Eck-Smit, Berthe L. F.
AU - Buller, Harry R.
AU - Bresser, Paul
PY - 2010
Y1 - 2010
N2 - Introduction: Chronic thromboembolic pulmonary hypertension (CTEPH) is a life threatening but often, by pulmonary endarterectomy, curable disease. The incidence of CTEPH after an acute pulmonary embolism (PE) appears to be much higher than previously thought. Systematic follow-up of patients after PE might increase the number of diagnosed CTEPH patients. Aim: To study whether, compared to current clinical practice, a systematic search for CTEPH in patients after acute PE would increase the number of patients diagnosed with symptomatic, potentially treatable CTEPH. Methods: Consecutive patients with a prior diagnosis of acute PE were presented with a questionnaire, designed to establish the presence of either new or worsened dyspnea after the acute PE episode. If so, patients were evaluated for the presence of CTEPH. Results: PE patients (n = 110; 56 +/- 18 years) were included after a median follow-up of three years. Overall mortality was 34% (37 patients); 1 patient had died due to CTEPH. In total 62 out of 69 questionnaires were returned; 23 patients reported new or worsened dyspnea related to the PE episode, and qualified for additional testing. In 2 patients, CTEPH was already diagnosed prior to this study. None of the remaining patients met the criteria for the diagnosis of CTEPH. The overall incidence of 2.7% (3/110; 95% CI 0.6-7.8%) is in agreement with earlier reported incidences. Conclusion: Our findings do not point to a role for a systematic search and pro-active approach towards patients with a recent history of pulmonary embolism to increase the number of patients diagnosed with potentially treatable CTEPH. (C) 2010 Elsevier Ltd. All rights reserved
AB - Introduction: Chronic thromboembolic pulmonary hypertension (CTEPH) is a life threatening but often, by pulmonary endarterectomy, curable disease. The incidence of CTEPH after an acute pulmonary embolism (PE) appears to be much higher than previously thought. Systematic follow-up of patients after PE might increase the number of diagnosed CTEPH patients. Aim: To study whether, compared to current clinical practice, a systematic search for CTEPH in patients after acute PE would increase the number of patients diagnosed with symptomatic, potentially treatable CTEPH. Methods: Consecutive patients with a prior diagnosis of acute PE were presented with a questionnaire, designed to establish the presence of either new or worsened dyspnea after the acute PE episode. If so, patients were evaluated for the presence of CTEPH. Results: PE patients (n = 110; 56 +/- 18 years) were included after a median follow-up of three years. Overall mortality was 34% (37 patients); 1 patient had died due to CTEPH. In total 62 out of 69 questionnaires were returned; 23 patients reported new or worsened dyspnea related to the PE episode, and qualified for additional testing. In 2 patients, CTEPH was already diagnosed prior to this study. None of the remaining patients met the criteria for the diagnosis of CTEPH. The overall incidence of 2.7% (3/110; 95% CI 0.6-7.8%) is in agreement with earlier reported incidences. Conclusion: Our findings do not point to a role for a systematic search and pro-active approach towards patients with a recent history of pulmonary embolism to increase the number of patients diagnosed with potentially treatable CTEPH. (C) 2010 Elsevier Ltd. All rights reserved
U2 - https://doi.org/10.1016/j.thromres.2009.12.016
DO - https://doi.org/10.1016/j.thromres.2009.12.016
M3 - Article
C2 - 20085846
SN - 0049-3848
VL - 125
SP - E202-E205
JO - Thrombosis research
JF - Thrombosis research
IS - 5
ER -