Document Detail


Active search for chronic thromboembolic pulmonary hypertension does not appear indicated after acute pulmonary embolism.
MedLine Citation:
PMID:  20085846     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Sulaiman Surie; Nadine S Gibson; Victor E A Gerdes; Berto J Bouma; Berthe L F van Eck-Smit; Harry R Buller; Paul Bresser
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Publication Detail:
Type:  Journal Article     Date:  2010-01-20
Journal Detail:
Title:  Thrombosis research     Volume:  125     ISSN:  1879-2472     ISO Abbreviation:  Thromb. Res.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-26     Completed Date:  2010-07-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0326377     Medline TA:  Thromb Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e202-5     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2009 Elsevier Ltd. All rights reserved.
Affiliation:
Department of Pulmonology, Academical Medical Center Amsterdam, the Netherlands. s.surie@amc.uva.nl
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MeSH Terms
Descriptor/Qualifier:
Causality
Comorbidity
Female
Humans
Hypertension, Pulmonary / diagnosis*,  epidemiology*
Male
Middle Aged
Netherlands / epidemiology
Prevalence
Pulmonary Embolism / diagnosis*,  epidemiology*
Risk Assessment / methods
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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