Document Detail

Incidence of chronic thromboembolic pulmonary hypertension after a first episode of pulmonary embolism.
MedLine Citation:
PMID:  16840398     Owner:  NLM     Status:  MEDLINE    
STUDY OBJECTIVE: To assess the incidence of chronic thromboembolic pulmonary hypertension (CTPH) after the first episode of objectively confirmed pulmonary embolism (PE). DESIGN: Prospective cohort study in 12 Italian medical centers. PATIENTS: Consecutive patients treated with oral anticoagulants for the first episode of PE, either idiopathic or associated with temporary risk factors, were followed up for at least 3 years. Patients were excluded from the study if they had a known persistent risk factor for venous thromboembolism (VTE). INTERVENTIONS: At the follow-up visits, patients were evaluated for persistent dyspnea, either at rest or on exertion. All patients who were referred with dyspnea were assessed by transthoracic echocardiography, with evaluation of the systolic and mean pulmonary artery pressures. Patients with evidence of pulmonary hypertension on echocardiography underwent perfusion lung scans and pulmonary angiography to confirm the diagnosis of CTPH. RESULTS: Overall, 259 patients were included in the study. PE was idiopathic in 135 patients, while it was associated with at least a temporary risk factor for VTE in 124 patients. After an average follow-up period of 46 months, 37 patients were found to have persistent dyspnea that was unexplained in 5 patients. Among these patients, a diagnosis of CTPH was confirmed in two patients with idiopathic PE (0.8% of the overall study population [95% confidence interval (CI), 0.0 to 1.9]; 1.5% of patients with idiopathic PE [95% CI, 0.0 to 3.6]). The diagnosis was made 14 and 22 months, respectively, after the acute PE. CONCLUSIONS: The incidence of CTPH observed in this study was about 1%. CTPH was observed in two patients with idiopathic PE.
Cecilia Becattini; Giancarlo Agnelli; Raffaele Pesavento; Mauro Silingardi; Renzo Poggio; Maria Rita Taliani; Walter Ageno
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Chest     Volume:  130     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-07-14     Completed Date:  2006-08-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  172-5     Citation Subset:  AIM; IM    
Dipartimento di Medicina Interna, Medicina Interna e Cardiovascolare, Università di Perugia, Via G. Dottori, Ospedale Silvestrini, 06129 Perugia, Italy.
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MeSH Terms
Anticoagulants / therapeutic use
Confidence Intervals
Dyspnea / etiology*,  ultrasonography
Follow-Up Studies
Hypertension, Pulmonary / epidemiology,  etiology*
Italy / epidemiology
Pulmonary Embolism / complications*,  drug therapy
Reg. No./Substance:

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