Incidence of Chronic Thromboembolic Pulmonary Hypertension after Pulmonary Embolism
Open accessAbstract
BACKGROUND: Chronic thromboembolic pulmonary hypertension (CTPH) is associated with considerable morbidity and mortality. Its incidence after pulmonary embolism and associated risk factors are not well documented. METHODS: We conducted a prospective, long-term, follow-up study to assess the incidence of symptomatic CTPH in consecutive patients with an acute episode of pulmonary embolism but without prior venous thromboembolism. Patients with unexplained persistent dyspnea during follow-up underwent transthoracic echocardiography and, if supportive findings were present, ventilation-perfusion lung scanning and pulmonary angiography. CTPH was considered to be present if systolic and mean pulmonary-artery pressures exceeded 40 mm Hg and 25 mm Hg, respectively; pulmonary-capillary wedge pressure was normal; and there was angiographic evidence of disease. RESULTS: The cumulative incidence of symptomatic CTPH was 1.0 percent (95 percent confidence interval, 0.0 to 2.4) at six months, 3.1 percent (95 percent confidence interval, 0.7 to 5.5) at one year, and 3.8 percent (95 percent confidence interval, 1.1 to 6.5) at two years. No cases occurred after two years among the patients with more than two years of follow-up data. The following increased the risk of CTPH: a previous pulmonary embolism (odds ratio, 19.0), younger age (odds ratio, 1.79 per decade), a larger perfusion defect (odds ratio, 2.22 per decile decrement in perfusion), and idiopathic pulmonary embolism at presentation (odds ratio, 5.70). CONCLUSIONS: CTPH is a relatively common, serious complication of pulmonary embolism. Diagnostic and therapeutic strategies for the early identification and prevention of CTPH are needed.
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Chronic thromboembolic pulmonary hypertension may develop in up to 5% of patients with PE.
“and chronic thromboembolic pulmonary hypertension, which may develop in up to 5% of patients with PE. 14”
From American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism (2020) · cites this paper as [14]
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Cites
The Long-Term Clinical Course of Acute Deep Venous Thrombosis
Prandoni, P., Lensing, A. W. A., Cogo, A., Cuppini, S., Villalta, S., Carta, M., Cattelan, A. M., Polistena, P., Bernardi, E., & Prins, M. H. (1996) · Annals of Internal Medicine · doi:10.7326/0003-4819-125-1-199607010-00001 · Cited by 2,094 · see citing works
Self-citationPrandoni, P., Lensing, A. W. A., Piccioli, A., Bernardi, E., Simioni, P., Girolami, B., Marchiori, A., Sabbion, P., Prins, M. H., Noventa, F., et al. (2002) · Blood · doi:10.1182/blood-2002-01-0108 · Cited by 1,863 · see citing works
Self-citationKoopman, M. M. W., Prandoni, P., Piovella, F., Ockelford, P., Brandjes, D. P. M., van der Meer, J., Gallus, A. S., Simonneau, G., Chesterman, C., Prins, M. H., et al. (1996) · New England Journal of Medicine · doi:10.1056/nejm199603143341102 · Cited by 1,105 · see citing works
Self-citationThe Clinical Course of Pulmonary Embolism
Carson, J. L., Kelley, M. A., Duff, A., Weg, J. G., Fulkerson, W. J., Palevsky, H. I., Schwartz, J. S., Thompson, B., Popovich, J., Hobbins, T. E., et al. (1992) · New England Journal of Medicine · doi:10.1056/nejm199205073261902 · Cited by 1,035 · see citing works
Low-Molecular-Weight Heparin in the Treatment of Patients with Venous Thromboembolism
The Columbus Investigators (1997) · New England Journal of Medicine · doi:10.1056/nejm199709043371001 · Cited by 788 · see citing works
Chronic Thromboembolic Pulmonary Hypertension
Fedullo, P. F., Auger, W. R., Kerr, K. M., & Rubin, L. J. (2001) · New England Journal of Medicine · doi:10.1056/nejmra010902 · Cited by 766 · see citing works
Guidelines on diagnosis and management of acute pulmonary embolism
(2000) · European Heart Journal · doi:10.1053/euhj.2000.2250 · Cited by 641 · see citing works
Goldhaber, S. Z. (1998) · New England Journal of Medicine · doi:10.1056/nejm199807093390207 · Cited by 448 · see citing works
Comparison of Streptokinase and Heparin in Treatment of Isolated Acute Massive Pulmonary Embolism
Miller, G. A. H., Sutton, G. C., Kerr, I. H., et al. (1971) · BMJ · doi:10.1136/bmj.2.5763.681 · Cited by 403 · see citing works
Management of Venous Thromboembolism
Ginsberg, J. S. (1996) · New England Journal of Medicine · doi:10.1056/nejm199612123352407 · Cited by 346 · see citing works
Thrombotic risk factors in pulmonary hypertension
Wolf, M., Boyer‐Neumann, C., Parent, F., Eschwège, V., Jaillet, H., Meyer, D., & Simonneau, G. (2000) · European Respiratory Journal · doi:10.1034/j.1399-3003.2000.15b28.x · Cited by 310 · see citing works
Chronic major-vessel thromboembolic pulmonary artery obstruction: appearance at angiography.
Auger, W. R., Fedullo, P. F., Moser, K. M., et al. (1992) · Radiology · doi:10.1148/radiology.182.2.1732955 · Cited by 302 · see citing works
Lensing, A. W. A., Prandoni, P., Prins, M. H., & Buller, H. R. (1999) · The Lancet · doi:10.1016/s0140-6736(98)04298-6 · Cited by 220 · see citing works
Self-citationEgermayer, P., & Peacock, A. (2000) · European Respiratory Journal · doi:10.1034/j.1399-3003.2000.15.03.x · Cited by 177 · see citing works
Auger, W. R., Permpikul, P., & Moser, K. Μ. (1995) · The American Journal of Medicine · doi:10.1016/s0002-9343(99)80187-9 · Cited by 120 · see citing works
The clinical course of patients with suspected pulmonary embolism
van Beek, E. J. (1997) · Archives of Internal Medicine · doi:10.1001/archinte.157.22.2593 · Cited by 115 · see citing works
Meyer, G., Collignon, M. A., Guinet, F., Jeffrey, A. A., Barritault, L., & Sors, H. (1990) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/bf01268022 · Cited by 101 · see citing works
Buller, H. R., Cariou, R., Gallus, A. S., Gent, M., Ginsberg, J., Prins, M. H., Lensing, A. W. A., Levi, M. M., Nurmohammed, N. S., Hirsh, J., et al. (2000) · Pure Amsterdam UMC · doi:10.1161/01.cir.102.22.2726 · Cited by 82 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 1
- [9]9. Otto CM. Textbook of clinical echocardiography. 2nd ed. Philadelphia: W.B. Saunders, 2000:123-31.
Cited by
Sorted by citations
Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association
Virani, S. S., Alonso, A., Benjamin, E. J., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Chang, A. R., Cheng, S., Delling, F. N., et al. (2020) · Circulation · doi:10.1161/cir.0000000000000757 · Cited by 9,175 · see citing works
Heart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association
Benjamin, E. J., Muntner, P., Alonso, A., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Chang, A. R., Cheng, S., Das, S. R., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000659 · Cited by 9,036 · see citing works
Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association
Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Anderson, C. A. M., Arora, P., Avery, C. L., Baker-Smith, C. M., Beaton, A. Z., Boehme, A. K., Buxton, A. E., et al. (2023) · Circulation · doi:10.1161/cir.0000000000001123 · Cited by 8,300 · see citing works
Heart disease and stroke statistics-2018 update: a report from the american heart association
Benjamin, E. J., Virani, S. S., Callaway, C. W., Chamberlain, A. M., Chang, A. R., Cheng, S., Chiuve, S. E., Cushman, M., Delling, F. N., Deo, R., et al. (2018) · Circulation · doi:10.1161/cir.0000000000000558 · Cited by 7,146 · see citing works
2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension
Galiè, N., Humbert, M., Vachiery, J.-L., Gibbs, S., Lang, I., Torbicki, A., Simonneau, G., Peacock, A., Vonk Noordegraaf, A., Beghetti, M., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehv317 · Cited by 6,931 · see citing works
Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association
Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Alonso, A., Beaton, A. Z., Bittencourt, M. S., Boehme, A. K., Buxton, A. E., Carson, A. P., Commodore-Mensah, Y., et al. (2022) · Circulation · doi:10.1161/cir.0000000000001052 · Cited by 5,987 · see citing works
Antithrombotic Therapy for VTE Disease
Kearon, C., Akl, E. A., Ornelas, J., Blaivas, A., Jimenez, D., Bounameaux, H., Huisman, M., King, C. S., Morris, T. A., Sood, N., et al. (2016) · Chest · doi:10.1016/j.chest.2015.11.026 · Cited by 4,830 · see citing works
Updated clinical classification of pulmonary hypertension
Simonneau, G., Gatzoulis, M. A., Adatia, I., Celermajer, D., Denton, C., Ghofrani, A., Gomez Sanchez, M. A., Krishna Kumar, R., Landzberg, M., Machado, R. F., et al. (2013) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.10.029 · Cited by 4,191 · see citing works
2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism
Authors/Task Force Members, Konstantinides, S. V., Torbicki, A., Agnelli, G., Danchin, N., Fitzmaurice, D., Galiè, N., Gibbs, J. S. R., Huisman, M. V., Humbert, M., et al. (2014) · European Heart Journal · doi:10.1093/eurheartj/ehu283 · Cited by 3,128 · see citing works
Ortel, T. L., Neumann, I., Ageno, W., Beyth, R., Clark, N. P., Cuker, A., Hutten, B. A., Jaff, M. R., Manja, V., Schulman, S., et al. (2020) · Blood Advances · doi:10.1182/bloodadvances.2020001830 · Cited by 1,489 · see citing works
“Long-term complications include PTS, which develops in 20% to 50% of patients after DVT and is severe in up to 5% of cases,(13) and chronic thromboembolic pulmonary hypertension, which may develop in up to 5% of patients with PE.(14)”
BackgroundInfluentialEffect of patient's sex on risk of recurrent venous thromboembolism: a meta-analysis.
McRae, S., Tran, H., Schulman, S., Ginsberg, J., & Kearon, C. (2006) · The Lancet · doi:10.1016/s0140-6736(06)69110-1 · Cited by 289 · see citing works
Lefebvre, P., Coleman, C. I., Bookhart, B. K., Wang, S.-T., Mody, S. H., Tran, K. N., Zhuo, D. Y., Huynh, L., & Nutescu, E. A. (2014) · Journal of Medical Economics · doi:10.3111/13696998.2013.858634 · Cited by 66 · see citing works
Bamber, L., Muston, D., McLeod, E., Guillermin, A., Lowin, J., & Patel, R. (2015) · Thrombosis Journal · doi:10.1186/s12959-015-0051-3 · Cited by 42 · see citing works
Oral anticoagulation strategies after a first idiopathic venous thromboembolic event
Aujesky, D., Smith, K. J., & Roberts, M. S. (2005) · The American Journal of Medicine · doi:10.1016/j.amjmed.2005.02.018 · Cited by 29 · see citing works
Jugrin, A. V., Ustyugova, A., Urbich, M., Sunderland, T., & Lamotte, M. (2015) · Thrombosis and Haemostasis · doi:10.1160/th14-12-1027 · Cited by 11 · see citing works
- Authors
- Pengo, V., Lensing, A. W. A., Prins, M. H., Marchiori, A., Davidson, B. L., Tiozzo, F., Albanese, P., Biasiolo, A., Pegoraro, C., Iliceto, S., & Prandoni, P.
- Affiliations
- Azienda Ospedale - Università Padova (IT)
- Amsterdam UMC Location University of Amsterdam (NL)
- Maastricht University Medical Centre (NL)
- University of Washington (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2004-05-27
- Volume
- 350
- Issue
- 22
- Pages
- 2257-2264
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2156573757
- Cited by
- 1,828
- References
- 18
- Citations by year
- 2026: 38 · 2025: 49 · 2024: 51 · 2023: 63 · 2022: 68 · 2021: 72 · 2020: 78 · 2019: 78 · 2018: 88 · 2017: 105 · 2016: 111 · 2015: 109 · 2014: 123 · 2013: 105 · 2012: 93
- FWCI
- 53.60
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Padua Research Archive (University of Padova) (submittedVersion, other-oa)
- CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Pulmonary Hypertension Research and Treatments
- Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
- Health Sciences › Medicine › Genetics › Vascular Anomalies and Treatments
- Keywords
- chronic thromboembolic pulmonary hypertension, pulmonary embolism, incidence, risk factors, idiopathic pulmonary embolism, perfusion defects, persistent dyspnea, pulmonary angiography, ventilation-perfusion lung scanning, transthoracic echocardiography
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Chronic Disease, Female, Follow-Up Studies, Humans, Hypertension, Pulmonary, Male, Middle Aged, Pulmonary Embolism, Recurrence, Risk Factors, Thromboembolism, Incidence, Logistic Models
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