Incidence and risk factors of chronic thromboembolic pulmonary hypertension in patients with diagnosis of pulmonary embolism for the first time in real world

Autor:	Li Yang, Lingli Liu, Xinpeng Han, Yongping Yu, Shuoyao Qu, Yuhai Zhang, Yaqin Chai, Xuemin Yang, Jingwen Xia, Liang Dong, Mengjie Niu, Ning Zhu, Shengqing Li, Liying Fang
Rok vydání:	2018
Předmět:	Pulmonary and Respiratory Medicine Adult Male medicine.medical_specialty Hypertension Pulmonary 030204 cardiovascular system & hematology Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine medicine.artery medicine Immunology and Allergy Humans Cumulative incidence Prospective Studies Pulmonary Wedge Pressure Pulmonary wedge pressure Genetics (clinical) Aged business.industry Incidence (epidemiology) Incidence Odds ratio Middle Aged medicine.disease Pulmonary hypertension Pulmonary embolism 030228 respiratory system Embolism Echocardiography Pulmonary artery Chronic Disease Cardiology Female business Pulmonary Embolism Follow-Up Studies
Zdroj:	The clinical respiratory journal. 12(11)
ISSN:	1752-699X
Popis:	Background The incidence and risk factors of chronic thromboembolic pulmonary hypertension (CTEPH) in patients with acute pulmonary embolism (PE) have been well reported. However, in real world, patients diagnosed with PE for the first time were usually composed of acute PE, sub-acute PE, and chronic PE, and the cumulative incidence and risk factors of CTEPH in this cohort were still unknown. Methods A prospective, long-term, follow-up study was conducted to assess the incidence of symptomatic CTEPH in consecutive patients with PE diagnosed for the first time. Patients with unexplained persistent dyspnea during follow-up underwent transthoracic echocardiography and, if the findings indicated pulmonary hypertension, ventilation-perfusion lung scanning and right heart catheterization. CTEPH was confirmed if perfusion defects were present, mean pulmonary artery pressure (mPAP) ≥25 mmHg and pulmonary artery wedge pressure (PAWP) ≤15 mmHg. Results The cumulative incidence of CTEPH in patients with PE diagnosed for the first time was 11.2% at 3 months, 12.7% at 1 year, 13.4% at 2 years, and 14.5% at 3 years. The following factors increased the risk of CTEPH: time from symptoms to treatment of PE ≥1 month (odds ratio (OR), 14.77), intermediate (OR, 37.63) to high risk PE (OR, 39.81), segmental and sub-segmental branch location of embolism (OR, 8.30) and PE-related primary risk factors (OR, 5.01). 9.4% of CTEPH patients developed from acute PE, and 90.6% from sub-acute and chronic PE. Conclusions In real world, CTEPH is a relatively common and serious complication in PE patients diagnosed for the first time. Early diagnosis and treatment of PE will decrease the incidence of CTEPH in these unspecified patients.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::63dfb327bc5f4f069ae18e14ef0f33b1 https://pubmed.ncbi.nlm.nih.gov/30160381 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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