Clot Burden As a Predictor of Chronic Thromboembolic Pulmonary Hypertension After Acute Pulmonary Embolism: A Cohort Study.

Autor:	Gharepapagh, Esmaeil, Rahimi, Fatemeh, Koohi, Ata, Bakhshandeh, Hooman, Mousavi-Aghdas, Seyed Ali, Sadeghipoor, Parham, Fakhari, Ashraf, Amirnia, Mehrad, Javadrashid, Reza, Rashidi, Farid
Předmět:	CHRONIC disease risk factors THROMBOEMBOLISM risk factors PATIENT aftercare STATISTICS PULMONARY embolism BLOOD vessels CONFIDENCE intervals PULMONARY hypertension RETROSPECTIVE studies RISK assessment THROMBOEMBOLISM DESCRIPTIVE statistics COMPUTED tomography ODDS ratio SENSITIVITY & specificity (Statistics) RECEIVER operating characteristic curves ACUTE diseases LONGITUDINAL method DISEASE risk factors
Zdroj:	Thoracic Research & Practice; Sep2023, Vol. 24 Issue 5, p276-281, 6p
Abstrakt:	OBJECTIVE: A small percentage of acute pulmonary thromboembolisms (PTE) persist as chronic fibrin clots, potentially leading to chronic thromboembolic pulmonary hypertension (CTEPH). A scoring system for evaluating the burden of acute PTE based on computed tomography pulmonary angiogram (CTPA) findings was tested for its association with CTEPH within one year. MATERIAL AND METHODS: In this retrospective cohort of 475 patients with a definitive diagnosis of acute PTE, the Qanadli score (QS) was calculated on the initial CTPA. Through regular follow-up over 1 year, symptomatic patients underwent extensive evaluation. RESULTS: Of the 475 patients enrolled in the study [age 58.3 ± 16.6, 195 (41.1%) female, QS: 13.01 ± 7.37/40], 321 patients completed the study. A total of 22 (6.8%) patients were definitively diagnosed with CTEPH. In univariate analysis, the initial QS was significantly higher in patients with subsequent CTEPH than in patients without (17 ± 5.6 vs. 13 ± 7.6, P = .009). QS was directly associated with CTEPH (odds ratio: 1.08, 95% confidence interval: 1.0-1.16, P = .042). The evolution of CTEPH in men could be predicted with a sensitivity of 100% and a specificity of 54% when a cut-off point of 14.5 (43.5%) was set for QS. The area under the receiver operating characteristic curve in this setting was 0.74 with a P-value of .032. Qanadli score failed to predict CTEPH in women. CONCLUSION: Scoring the clot burden in the pulmonary arteries through the Qanadli method can predict the evolution of CTEPH only in men 1 year after acute PTE. Women comprise most of the CTEPH patients. Thus, strict follow-up adherence seems to be even more important in women. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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