Frequency and predictors for chronic thromboembolic pulmonary hypertension after a first unprovoked pulmonary embolism: Results from PADIS studies
Background Chronic thromboembolic pulmonary hypertension (CTEPH) is a life‐threatening complication of a pulmonary embolism (PE) whose incidence and predictors are not precisely determined. Objective To determine the frequency and predictors for CTEPH after a first unprovoked PE. Patients/Methods In...
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| Veröffentlicht in: | Journal of thrombosis and haemostasis 2022-12, Vol.20 (12), p.2850-2861 |
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| creator | Fauché, Alexandre Presles, Emilie Sanchez, Olivier Jaïs, Xavier Le Mao, Raphael Robin, Philippe Pernod, Gilles Bertoletti, Laurent Jego, Patrick Parent, Florence Lemarié, Catherine A. Leven, Florent Le Roux, Pierre‐Yves Salaun, Pierre‐Yves Nonent, Michel Girard, Philippe Lacut, Karine Savale, Laurent Mélac, Solen Guégan, Marie Mismetti, Patrick Laporte, Silvy Leroyer, Christophe Montani, David Couturaud, Francis Tromeur, Cécile Couturaud, Francis Mismetti, Patrick Leroyer, Christophe Meyer, Guy Sanchez, Olivier Jego, Patrick Pernod, Gilles Duhamel, Elisabeth Provost, Karine Parent, Florence Bertoletti, Laurent Tromeur, Cécile Mottier, Dominique Guégan, Marie Mélac, Solen Le Hir, Aurélia Girard, Philippe Lenoir, Stéphane Lamer, Christian Bergmann, Jean François Wahl, Denis Drouet, Ludovic Presles, Emilie Laporte, Silvy Chevarier, Patrick Monte, Nicolas Morvan, Florence Kouassi, Véronique Ibrir, Nabahats El Asri, Gaid Salaun, Pierre Yves Robin, Philippe Le Roux, Pierre Yves Bressollette, Luc Quéhé, Philippe Gestin, Simon Nonent, Michel Bahuon, Jérôme Deloire, Lucille Planquette, Benjamin Jobic, Yannick Etienne, Yves Didier, Romain Leven, Florent Leroux, Loic Galinat, Hubert Le Maréchal, Cédric Gourhant, Lénaïck Mingant, Fanny Lacut, Karine Lemoigne, Emmanuelle De Saint Martin, Luc Delluc, Aurélien Le Gal, Grégoire Paleiron, Nicolas Le Mao, Raphaël Pison, Christophe Guéret, Philippe Décousus, Hervé Accassat, Sandrine |
| description | Background
Chronic thromboembolic pulmonary hypertension (CTEPH) is a life‐threatening complication of a pulmonary embolism (PE) whose incidence and predictors are not precisely determined.
Objective
To determine the frequency and predictors for CTEPH after a first unprovoked PE.
Patients/Methods
In a randomized trial comparing an additional 18‐month warfarin versus placebo in patients after a first unprovoked PE initially treated with vitamin K antagonist for 6 months, we applied recommended CTEPH screening strategies through an 8‐year follow‐up to determine cumulative incidence of CTEPH. CTEPH predictors were estimated using Cox models. Pulmonary vascular obstruction (PVO) and systolic pulmonary arterial pressure (sPAP) at PE diagnosis and 6 months were studied by receiver operating curves analysis. All CTEPH cases and whether they were incident or prevalent were adjudicated.
Results
During a median follow‐up of 8.7 years, nine CTEPH cases were diagnosed among 371 patients, with a cumulative incidence of 2.8% (95% confidence interval [CI] 0.95–4.64), and of 1.31% (95% CI 0.01–2.60) after exclusion of five cases adjudicated as prevalent. At PE diagnosis, PVO > 45% and sPAP > 56 mmHg were associated with CTEPH with a hazard ratio (HR) of 33.00 (95% CI 1.64–667.00, p = .02) and 12.50 (95% CI 2.10–74.80, p 65 years, lupus anticoagulant antibodies and non‐O blood groups were also predictive of CTEPH. PVO > 14% and sPAP > 34 mmHg at 6 months were associated with CTEPH (HR 63.90 [95% CI 3.11–1310.00, p |
| doi_str_mv | 10.1111/jth.15866 |
| format | Article |
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Chronic thromboembolic pulmonary hypertension (CTEPH) is a life‐threatening complication of a pulmonary embolism (PE) whose incidence and predictors are not precisely determined.
Objective
To determine the frequency and predictors for CTEPH after a first unprovoked PE.
Patients/Methods
In a randomized trial comparing an additional 18‐month warfarin versus placebo in patients after a first unprovoked PE initially treated with vitamin K antagonist for 6 months, we applied recommended CTEPH screening strategies through an 8‐year follow‐up to determine cumulative incidence of CTEPH. CTEPH predictors were estimated using Cox models. Pulmonary vascular obstruction (PVO) and systolic pulmonary arterial pressure (sPAP) at PE diagnosis and 6 months were studied by receiver operating curves analysis. All CTEPH cases and whether they were incident or prevalent were adjudicated.
Results
During a median follow‐up of 8.7 years, nine CTEPH cases were diagnosed among 371 patients, with a cumulative incidence of 2.8% (95% confidence interval [CI] 0.95–4.64), and of 1.31% (95% CI 0.01–2.60) after exclusion of five cases adjudicated as prevalent. At PE diagnosis, PVO > 45% and sPAP > 56 mmHg were associated with CTEPH with a hazard ratio (HR) of 33.00 (95% CI 1.64–667.00, p = .02) and 12.50 (95% CI 2.10–74.80, p < .01), respectively. Age > 65 years, lupus anticoagulant antibodies and non‐O blood groups were also predictive of CTEPH. PVO > 14% and sPAP > 34 mmHg at 6 months were associated with CTEPH (HR 63.90 [95% CI 3.11–1310.00, p < .01]and HR 17.2 [95% CI 2.75–108, p < .01]).
Conclusion
After a first unprovoked PE, CTEPH cumulative incidence was 2.8% during an 8‐year follow‐up. PVO and sPAP at PE diagnosis and at 6 months were the main predictors for CTEPH diagnosis.</description><identifier>ISSN: 1538-7933</identifier><identifier>ISSN: 1538-7836</identifier><identifier>EISSN: 1538-7836</identifier><identifier>DOI: 10.1111/jth.15866</identifier><identifier>PMID: 36017744</identifier><language>eng</language><publisher>England: Elsevier Limited</publisher><subject>Aged ; Anticoagulants ; Anticoagulants - therapeutic use ; Blood groups ; Blood pressure ; Chronic Disease ; clinical studies ; Diagnosis ; Embolism ; Humans ; Hypertension ; Hypertension, Pulmonary - complications ; Hypertension, Pulmonary - diagnosis ; Hypertension, Pulmonary - epidemiology ; incidence ; Life Sciences ; pulmonary embolism ; Pulmonary Embolism - complications ; Pulmonary Embolism - diagnosis ; Pulmonary Embolism - epidemiology ; Pulmonary embolisms ; Pulmonary hypertension ; Risk Factors ; Thromboembolism ; Vitamin K</subject><ispartof>Journal of thrombosis and haemostasis, 2022-12, Vol.20 (12), p.2850-2861</ispartof><rights>2022 International Society on Thrombosis and Haemostasis.</rights><rights>2022 International Society on Thrombosis and Haemostasis</rights><rights>Attribution - NonCommercial</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4226-5856b58afdb846540e31c3bd1e02e5bb232467b43d552f7d822b22c670d8379e3</citedby><cites>FETCH-LOGICAL-c4226-5856b58afdb846540e31c3bd1e02e5bb232467b43d552f7d822b22c670d8379e3</cites><orcidid>0000-0002-1855-8032 ; 0000-0002-1317-8997 ; 0000-0003-1633-8391 ; 0000-0002-3874-9119 ; 0000-0002-6862-8975 ; 0000-0003-1511-0555 ; 0000-0001-5521-9454 ; 0000-0002-3899-2135 ; 0000-0001-6494-5984 ; 0000-0002-8534-8203 ; 0000-0002-1559-8055 ; 0000-0001-9151-0775 ; 0000-0003-4489-5697 ; 0000-0003-3568-7079 ; 0000-0002-9358-6922 ; 0000-0002-7601-1692 ; 0000-0001-6197-8668 ; 0000-0001-9161-7521 ; 0000-0002-3897-4287 ; 0000-0001-5216-5278 ; 0000-0002-8581-6580 ; 0000-0001-8214-3010 ; 0000-0003-0555-1816</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36017744$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://univ-rennes.hal.science/hal-03800679$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Fauché, Alexandre</creatorcontrib><creatorcontrib>Presles, Emilie</creatorcontrib><creatorcontrib>Sanchez, Olivier</creatorcontrib><creatorcontrib>Jaïs, Xavier</creatorcontrib><creatorcontrib>Le Mao, Raphael</creatorcontrib><creatorcontrib>Robin, Philippe</creatorcontrib><creatorcontrib>Pernod, Gilles</creatorcontrib><creatorcontrib>Bertoletti, Laurent</creatorcontrib><creatorcontrib>Jego, Patrick</creatorcontrib><creatorcontrib>Parent, Florence</creatorcontrib><creatorcontrib>Lemarié, Catherine A.</creatorcontrib><creatorcontrib>Leven, Florent</creatorcontrib><creatorcontrib>Le Roux, Pierre‐Yves</creatorcontrib><creatorcontrib>Salaun, Pierre‐Yves</creatorcontrib><creatorcontrib>Nonent, Michel</creatorcontrib><creatorcontrib>Girard, Philippe</creatorcontrib><creatorcontrib>Lacut, Karine</creatorcontrib><creatorcontrib>Savale, Laurent</creatorcontrib><creatorcontrib>Mélac, Solen</creatorcontrib><creatorcontrib>Guégan, Marie</creatorcontrib><creatorcontrib>Mismetti, Patrick</creatorcontrib><creatorcontrib>Laporte, Silvy</creatorcontrib><creatorcontrib>Leroyer, Christophe</creatorcontrib><creatorcontrib>Montani, David</creatorcontrib><creatorcontrib>Couturaud, Francis</creatorcontrib><creatorcontrib>Tromeur, Cécile</creatorcontrib><creatorcontrib>Couturaud, Francis</creatorcontrib><creatorcontrib>Mismetti, Patrick</creatorcontrib><creatorcontrib>Leroyer, Christophe</creatorcontrib><creatorcontrib>Meyer, Guy</creatorcontrib><creatorcontrib>Sanchez, Olivier</creatorcontrib><creatorcontrib>Jego, Patrick</creatorcontrib><creatorcontrib>Pernod, Gilles</creatorcontrib><creatorcontrib>Duhamel, Elisabeth</creatorcontrib><creatorcontrib>Provost, Karine</creatorcontrib><creatorcontrib>Parent, Florence</creatorcontrib><creatorcontrib>Bertoletti, Laurent</creatorcontrib><creatorcontrib>Tromeur, Cécile</creatorcontrib><creatorcontrib>Mottier, Dominique</creatorcontrib><creatorcontrib>Guégan, Marie</creatorcontrib><creatorcontrib>Mélac, Solen</creatorcontrib><creatorcontrib>Le Hir, Aurélia</creatorcontrib><creatorcontrib>Girard, Philippe</creatorcontrib><creatorcontrib>Lenoir, Stéphane</creatorcontrib><creatorcontrib>Lamer, Christian</creatorcontrib><creatorcontrib>Bergmann, Jean François</creatorcontrib><creatorcontrib>Wahl, Denis</creatorcontrib><creatorcontrib>Drouet, Ludovic</creatorcontrib><creatorcontrib>Presles, Emilie</creatorcontrib><creatorcontrib>Laporte, Silvy</creatorcontrib><creatorcontrib>Chevarier, Patrick</creatorcontrib><creatorcontrib>Monte, Nicolas</creatorcontrib><creatorcontrib>Morvan, Florence</creatorcontrib><creatorcontrib>Kouassi, Véronique</creatorcontrib><creatorcontrib>Ibrir, Nabahats</creatorcontrib><creatorcontrib>El Asri, Gaid</creatorcontrib><creatorcontrib>Salaun, Pierre Yves</creatorcontrib><creatorcontrib>Robin, Philippe</creatorcontrib><creatorcontrib>Le Roux, Pierre Yves</creatorcontrib><creatorcontrib>Bressollette, Luc</creatorcontrib><creatorcontrib>Quéhé, Philippe</creatorcontrib><creatorcontrib>Gestin, Simon</creatorcontrib><creatorcontrib>Nonent, Michel</creatorcontrib><creatorcontrib>Bahuon, Jérôme</creatorcontrib><creatorcontrib>Deloire, Lucille</creatorcontrib><creatorcontrib>Planquette, Benjamin</creatorcontrib><creatorcontrib>Jobic, Yannick</creatorcontrib><creatorcontrib>Etienne, Yves</creatorcontrib><creatorcontrib>Didier, Romain</creatorcontrib><creatorcontrib>Leven, Florent</creatorcontrib><creatorcontrib>Leroux, Loic</creatorcontrib><creatorcontrib>Galinat, Hubert</creatorcontrib><creatorcontrib>Le Maréchal, Cédric</creatorcontrib><creatorcontrib>Gourhant, Lénaïck</creatorcontrib><creatorcontrib>Mingant, Fanny</creatorcontrib><creatorcontrib>Lacut, Karine</creatorcontrib><creatorcontrib>Lemoigne, Emmanuelle</creatorcontrib><creatorcontrib>De Saint Martin, Luc</creatorcontrib><creatorcontrib>Delluc, Aurélien</creatorcontrib><creatorcontrib>Le Gal, Grégoire</creatorcontrib><creatorcontrib>Paleiron, Nicolas</creatorcontrib><creatorcontrib>Le Mao, Raphaël</creatorcontrib><creatorcontrib>Pison, Christophe</creatorcontrib><creatorcontrib>Guéret, Philippe</creatorcontrib><creatorcontrib>Décousus, Hervé</creatorcontrib><creatorcontrib>Accassat, Sandrine</creatorcontrib><creatorcontrib>PADIS-PE Investigators</creatorcontrib><title>Frequency and predictors for chronic thromboembolic pulmonary hypertension after a first unprovoked pulmonary embolism: Results from PADIS studies</title><title>Journal of thrombosis and haemostasis</title><addtitle>J Thromb Haemost</addtitle><description>Background
Chronic thromboembolic pulmonary hypertension (CTEPH) is a life‐threatening complication of a pulmonary embolism (PE) whose incidence and predictors are not precisely determined.
Objective
To determine the frequency and predictors for CTEPH after a first unprovoked PE.
Patients/Methods
In a randomized trial comparing an additional 18‐month warfarin versus placebo in patients after a first unprovoked PE initially treated with vitamin K antagonist for 6 months, we applied recommended CTEPH screening strategies through an 8‐year follow‐up to determine cumulative incidence of CTEPH. CTEPH predictors were estimated using Cox models. Pulmonary vascular obstruction (PVO) and systolic pulmonary arterial pressure (sPAP) at PE diagnosis and 6 months were studied by receiver operating curves analysis. All CTEPH cases and whether they were incident or prevalent were adjudicated.
Results
During a median follow‐up of 8.7 years, nine CTEPH cases were diagnosed among 371 patients, with a cumulative incidence of 2.8% (95% confidence interval [CI] 0.95–4.64), and of 1.31% (95% CI 0.01–2.60) after exclusion of five cases adjudicated as prevalent. At PE diagnosis, PVO > 45% and sPAP > 56 mmHg were associated with CTEPH with a hazard ratio (HR) of 33.00 (95% CI 1.64–667.00, p = .02) and 12.50 (95% CI 2.10–74.80, p < .01), respectively. Age > 65 years, lupus anticoagulant antibodies and non‐O blood groups were also predictive of CTEPH. PVO > 14% and sPAP > 34 mmHg at 6 months were associated with CTEPH (HR 63.90 [95% CI 3.11–1310.00, p < .01]and HR 17.2 [95% CI 2.75–108, p < .01]).
Conclusion
After a first unprovoked PE, CTEPH cumulative incidence was 2.8% during an 8‐year follow‐up. PVO and sPAP at PE diagnosis and at 6 months were the main predictors for CTEPH diagnosis.</description><subject>Aged</subject><subject>Anticoagulants</subject><subject>Anticoagulants - therapeutic use</subject><subject>Blood groups</subject><subject>Blood pressure</subject><subject>Chronic Disease</subject><subject>clinical studies</subject><subject>Diagnosis</subject><subject>Embolism</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension, Pulmonary - complications</subject><subject>Hypertension, Pulmonary - diagnosis</subject><subject>Hypertension, Pulmonary - epidemiology</subject><subject>incidence</subject><subject>Life Sciences</subject><subject>pulmonary embolism</subject><subject>Pulmonary Embolism - complications</subject><subject>Pulmonary Embolism - diagnosis</subject><subject>Pulmonary Embolism - epidemiology</subject><subject>Pulmonary embolisms</subject><subject>Pulmonary hypertension</subject><subject>Risk Factors</subject><subject>Thromboembolism</subject><subject>Vitamin K</subject><issn>1538-7933</issn><issn>1538-7836</issn><issn>1538-7836</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kdtu1DAQhiMEoqVwwQsgS9zQi219iO0sd6vSskUrgaBcWz5MtF6SONhO0b4GT4yXtAUhYWk0Y-vTPzP-q-olwWeknPNd3p4R3gjxqDomnDUL2TDx-L5eMnZUPUtphzFZcoqfVkdMYCJlXR9XP68ifJ9gsHukB4fGCM7bHGJCbYjIbmMYvEW55N4EKNGV6zh1fRh03KPtfoSYYUg-DEi3GSLSqPUxZTQNYwy34Ru4v_hZIfVv0WdIU5dLm6KMPq3eXX9BKU_OQ3pePWl1l-DFXT6pvl5d3lysF5uP768vVpuFrSkVC95wYXijW2eaWvAaAyOWGUcAU-DGUEZrIU3NHOe0la6h1FBqhcSuYXIJ7KQ6nXW3ulNj9H0ZUAXt1Xq1UYc3zBqMhVzeksK-mdmyU_mulFXvk4Wu0wOEKSkqsRSYlk4Fff0PugtTHMomhWJcHIL-aW5jSClC-zABwepgqiqmqt-mFvbVneJkenAP5L2LBTifgR--g_3_ldSHm_Us-QuAbqzv</recordid><startdate>202212</startdate><enddate>202212</enddate><creator>Fauché, Alexandre</creator><creator>Presles, Emilie</creator><creator>Sanchez, Olivier</creator><creator>Jaïs, Xavier</creator><creator>Le Mao, Raphael</creator><creator>Robin, Philippe</creator><creator>Pernod, Gilles</creator><creator>Bertoletti, Laurent</creator><creator>Jego, Patrick</creator><creator>Parent, Florence</creator><creator>Lemarié, Catherine A.</creator><creator>Leven, Florent</creator><creator>Le Roux, Pierre‐Yves</creator><creator>Salaun, Pierre‐Yves</creator><creator>Nonent, Michel</creator><creator>Girard, Philippe</creator><creator>Lacut, Karine</creator><creator>Savale, Laurent</creator><creator>Mélac, Solen</creator><creator>Guégan, Marie</creator><creator>Mismetti, Patrick</creator><creator>Laporte, Silvy</creator><creator>Leroyer, Christophe</creator><creator>Montani, David</creator><creator>Couturaud, Francis</creator><creator>Tromeur, Cécile</creator><creator>Couturaud, Francis</creator><creator>Mismetti, Patrick</creator><creator>Leroyer, Christophe</creator><creator>Meyer, Guy</creator><creator>Sanchez, 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Limited</general><general>Wiley</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><orcidid>https://orcid.org/0000-0002-1855-8032</orcidid><orcidid>https://orcid.org/0000-0002-1317-8997</orcidid><orcidid>https://orcid.org/0000-0003-1633-8391</orcidid><orcidid>https://orcid.org/0000-0002-3874-9119</orcidid><orcidid>https://orcid.org/0000-0002-6862-8975</orcidid><orcidid>https://orcid.org/0000-0003-1511-0555</orcidid><orcidid>https://orcid.org/0000-0001-5521-9454</orcidid><orcidid>https://orcid.org/0000-0002-3899-2135</orcidid><orcidid>https://orcid.org/0000-0001-6494-5984</orcidid><orcidid>https://orcid.org/0000-0002-8534-8203</orcidid><orcidid>https://orcid.org/0000-0002-1559-8055</orcidid><orcidid>https://orcid.org/0000-0001-9151-0775</orcidid><orcidid>https://orcid.org/0000-0003-4489-5697</orcidid><orcidid>https://orcid.org/0000-0003-3568-7079</orcidid><orcidid>https://orcid.org/0000-0002-9358-6922</orcidid><orcidid>https://orcid.org/0000-0002-7601-1692</orcidid><orcidid>https://orcid.org/0000-0001-6197-8668</orcidid><orcidid>https://orcid.org/0000-0001-9161-7521</orcidid><orcidid>https://orcid.org/0000-0002-3897-4287</orcidid><orcidid>https://orcid.org/0000-0001-5216-5278</orcidid><orcidid>https://orcid.org/0000-0002-8581-6580</orcidid><orcidid>https://orcid.org/0000-0001-8214-3010</orcidid><orcidid>https://orcid.org/0000-0003-0555-1816</orcidid></search><sort><creationdate>202212</creationdate><title>Frequency and predictors for chronic thromboembolic pulmonary hypertension after a first unprovoked pulmonary embolism: Results from PADIS studies</title><author>Fauché, Alexandre ; Presles, Emilie ; Sanchez, Olivier ; Jaïs, Xavier ; Le Mao, Raphael ; Robin, Philippe ; Pernod, Gilles ; Bertoletti, Laurent ; Jego, Patrick ; Parent, Florence ; Lemarié, Catherine A. ; Leven, Florent ; Le Roux, Pierre‐Yves ; Salaun, Pierre‐Yves ; Nonent, Michel ; Girard, Philippe ; Lacut, Karine ; Savale, Laurent ; Mélac, Solen ; Guégan, Marie ; Mismetti, Patrick ; Laporte, Silvy ; Leroyer, Christophe ; Montani, David ; Couturaud, Francis ; Tromeur, Cécile ; Couturaud, Francis ; Mismetti, Patrick ; Leroyer, Christophe ; Meyer, Guy ; Sanchez, Olivier ; Jego, Patrick ; Pernod, Gilles ; Duhamel, Elisabeth ; Provost, Karine ; Parent, Florence ; Bertoletti, Laurent ; Tromeur, Cécile ; Mottier, Dominique ; Guégan, Marie ; Mélac, Solen ; Le Hir, Aurélia ; Girard, Philippe ; Lenoir, Stéphane ; Lamer, Christian ; Bergmann, Jean François ; Wahl, Denis ; Drouet, Ludovic ; Presles, Emilie ; Laporte, Silvy ; Chevarier, Patrick ; Monte, Nicolas ; Morvan, Florence ; Kouassi, Véronique ; Ibrir, Nabahats ; El Asri, Gaid ; Salaun, Pierre Yves ; Robin, Philippe ; Le Roux, Pierre Yves ; Bressollette, Luc ; Quéhé, Philippe ; Gestin, Simon ; Nonent, Michel ; Bahuon, Jérôme ; Deloire, Lucille ; Planquette, Benjamin ; Jobic, Yannick ; Etienne, Yves ; Didier, Romain ; Leven, Florent ; Leroux, Loic ; Galinat, Hubert ; Le Maréchal, Cédric ; Gourhant, Lénaïck ; Mingant, Fanny ; Lacut, Karine ; Lemoigne, Emmanuelle ; De Saint Martin, Luc ; Delluc, Aurélien ; Le Gal, Grégoire ; Paleiron, Nicolas ; Le Mao, Raphaël ; Pison, Christophe ; Guéret, Philippe ; Décousus, Hervé ; Accassat, Sandrine</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4226-5856b58afdb846540e31c3bd1e02e5bb232467b43d552f7d822b22c670d8379e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Aged</topic><topic>Anticoagulants</topic><topic>Anticoagulants - therapeutic use</topic><topic>Blood groups</topic><topic>Blood pressure</topic><topic>Chronic Disease</topic><topic>clinical studies</topic><topic>Diagnosis</topic><topic>Embolism</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension, Pulmonary - complications</topic><topic>Hypertension, Pulmonary - diagnosis</topic><topic>Hypertension, Pulmonary - epidemiology</topic><topic>incidence</topic><topic>Life Sciences</topic><topic>pulmonary embolism</topic><topic>Pulmonary Embolism - complications</topic><topic>Pulmonary Embolism - diagnosis</topic><topic>Pulmonary Embolism - epidemiology</topic><topic>Pulmonary embolisms</topic><topic>Pulmonary hypertension</topic><topic>Risk Factors</topic><topic>Thromboembolism</topic><topic>Vitamin K</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fauché, Alexandre</creatorcontrib><creatorcontrib>Presles, Emilie</creatorcontrib><creatorcontrib>Sanchez, Olivier</creatorcontrib><creatorcontrib>Jaïs, Xavier</creatorcontrib><creatorcontrib>Le Mao, Raphael</creatorcontrib><creatorcontrib>Robin, Philippe</creatorcontrib><creatorcontrib>Pernod, Gilles</creatorcontrib><creatorcontrib>Bertoletti, Laurent</creatorcontrib><creatorcontrib>Jego, Patrick</creatorcontrib><creatorcontrib>Parent, Florence</creatorcontrib><creatorcontrib>Lemarié, Catherine A.</creatorcontrib><creatorcontrib>Leven, Florent</creatorcontrib><creatorcontrib>Le Roux, Pierre‐Yves</creatorcontrib><creatorcontrib>Salaun, Pierre‐Yves</creatorcontrib><creatorcontrib>Nonent, Michel</creatorcontrib><creatorcontrib>Girard, 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- Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><jtitle>Journal of thrombosis and haemostasis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fauché, Alexandre</au><au>Presles, Emilie</au><au>Sanchez, Olivier</au><au>Jaïs, Xavier</au><au>Le Mao, Raphael</au><au>Robin, Philippe</au><au>Pernod, Gilles</au><au>Bertoletti, Laurent</au><au>Jego, Patrick</au><au>Parent, Florence</au><au>Lemarié, Catherine A.</au><au>Leven, Florent</au><au>Le Roux, Pierre‐Yves</au><au>Salaun, Pierre‐Yves</au><au>Nonent, Michel</au><au>Girard, Philippe</au><au>Lacut, Karine</au><au>Savale, Laurent</au><au>Mélac, Solen</au><au>Guégan, Marie</au><au>Mismetti, Patrick</au><au>Laporte, Silvy</au><au>Leroyer, Christophe</au><au>Montani, David</au><au>Couturaud, Francis</au><au>Tromeur, Cécile</au><au>Couturaud, Francis</au><au>Mismetti, Patrick</au><au>Leroyer, Christophe</au><au>Meyer, Guy</au><au>Sanchez, Olivier</au><au>Jego, Patrick</au><au>Pernod, Gilles</au><au>Duhamel, Elisabeth</au><au>Provost, Karine</au><au>Parent, Florence</au><au>Bertoletti, Laurent</au><au>Tromeur, Cécile</au><au>Mottier, Dominique</au><au>Guégan, Marie</au><au>Mélac, Solen</au><au>Le Hir, Aurélia</au><au>Girard, Philippe</au><au>Lenoir, Stéphane</au><au>Lamer, Christian</au><au>Bergmann, Jean François</au><au>Wahl, Denis</au><au>Drouet, Ludovic</au><au>Presles, Emilie</au><au>Laporte, Silvy</au><au>Chevarier, Patrick</au><au>Monte, Nicolas</au><au>Morvan, Florence</au><au>Kouassi, Véronique</au><au>Ibrir, Nabahats</au><au>El Asri, Gaid</au><au>Salaun, Pierre Yves</au><au>Robin, Philippe</au><au>Le Roux, Pierre Yves</au><au>Bressollette, Luc</au><au>Quéhé, Philippe</au><au>Gestin, Simon</au><au>Nonent, Michel</au><au>Bahuon, Jérôme</au><au>Deloire, Lucille</au><au>Planquette, Benjamin</au><au>Jobic, Yannick</au><au>Etienne, Yves</au><au>Didier, Romain</au><au>Leven, Florent</au><au>Leroux, Loic</au><au>Galinat, Hubert</au><au>Le Maréchal, Cédric</au><au>Gourhant, Lénaïck</au><au>Mingant, Fanny</au><au>Lacut, Karine</au><au>Lemoigne, Emmanuelle</au><au>De Saint Martin, Luc</au><au>Delluc, Aurélien</au><au>Le Gal, Grégoire</au><au>Paleiron, Nicolas</au><au>Le Mao, Raphaël</au><au>Pison, Christophe</au><au>Guéret, Philippe</au><au>Décousus, Hervé</au><au>Accassat, Sandrine</au><aucorp>PADIS-PE Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Frequency and predictors for chronic thromboembolic pulmonary hypertension after a first unprovoked pulmonary embolism: Results from PADIS studies</atitle><jtitle>Journal of thrombosis and haemostasis</jtitle><addtitle>J Thromb Haemost</addtitle><date>2022-12</date><risdate>2022</risdate><volume>20</volume><issue>12</issue><spage>2850</spage><epage>2861</epage><pages>2850-2861</pages><issn>1538-7933</issn><issn>1538-7836</issn><eissn>1538-7836</eissn><abstract>Background
Chronic thromboembolic pulmonary hypertension (CTEPH) is a life‐threatening complication of a pulmonary embolism (PE) whose incidence and predictors are not precisely determined.
Objective
To determine the frequency and predictors for CTEPH after a first unprovoked PE.
Patients/Methods
In a randomized trial comparing an additional 18‐month warfarin versus placebo in patients after a first unprovoked PE initially treated with vitamin K antagonist for 6 months, we applied recommended CTEPH screening strategies through an 8‐year follow‐up to determine cumulative incidence of CTEPH. CTEPH predictors were estimated using Cox models. Pulmonary vascular obstruction (PVO) and systolic pulmonary arterial pressure (sPAP) at PE diagnosis and 6 months were studied by receiver operating curves analysis. All CTEPH cases and whether they were incident or prevalent were adjudicated.
Results
During a median follow‐up of 8.7 years, nine CTEPH cases were diagnosed among 371 patients, with a cumulative incidence of 2.8% (95% confidence interval [CI] 0.95–4.64), and of 1.31% (95% CI 0.01–2.60) after exclusion of five cases adjudicated as prevalent. At PE diagnosis, PVO > 45% and sPAP > 56 mmHg were associated with CTEPH with a hazard ratio (HR) of 33.00 (95% CI 1.64–667.00, p = .02) and 12.50 (95% CI 2.10–74.80, p < .01), respectively. Age > 65 years, lupus anticoagulant antibodies and non‐O blood groups were also predictive of CTEPH. PVO > 14% and sPAP > 34 mmHg at 6 months were associated with CTEPH (HR 63.90 [95% CI 3.11–1310.00, p < .01]and HR 17.2 [95% CI 2.75–108, p < .01]).
Conclusion
After a first unprovoked PE, CTEPH cumulative incidence was 2.8% during an 8‐year follow‐up. PVO and sPAP at PE diagnosis and at 6 months were the main predictors for CTEPH diagnosis.</abstract><cop>England</cop><pub>Elsevier Limited</pub><pmid>36017744</pmid><doi>10.1111/jth.15866</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-1855-8032</orcidid><orcidid>https://orcid.org/0000-0002-1317-8997</orcidid><orcidid>https://orcid.org/0000-0003-1633-8391</orcidid><orcidid>https://orcid.org/0000-0002-3874-9119</orcidid><orcidid>https://orcid.org/0000-0002-6862-8975</orcidid><orcidid>https://orcid.org/0000-0003-1511-0555</orcidid><orcidid>https://orcid.org/0000-0001-5521-9454</orcidid><orcidid>https://orcid.org/0000-0002-3899-2135</orcidid><orcidid>https://orcid.org/0000-0001-6494-5984</orcidid><orcidid>https://orcid.org/0000-0002-8534-8203</orcidid><orcidid>https://orcid.org/0000-0002-1559-8055</orcidid><orcidid>https://orcid.org/0000-0001-9151-0775</orcidid><orcidid>https://orcid.org/0000-0003-4489-5697</orcidid><orcidid>https://orcid.org/0000-0003-3568-7079</orcidid><orcidid>https://orcid.org/0000-0002-9358-6922</orcidid><orcidid>https://orcid.org/0000-0002-7601-1692</orcidid><orcidid>https://orcid.org/0000-0001-6197-8668</orcidid><orcidid>https://orcid.org/0000-0001-9161-7521</orcidid><orcidid>https://orcid.org/0000-0002-3897-4287</orcidid><orcidid>https://orcid.org/0000-0001-5216-5278</orcidid><orcidid>https://orcid.org/0000-0002-8581-6580</orcidid><orcidid>https://orcid.org/0000-0001-8214-3010</orcidid><orcidid>https://orcid.org/0000-0003-0555-1816</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1538-7933 |
| ispartof | Journal of thrombosis and haemostasis, 2022-12, Vol.20 (12), p.2850-2861 |
| issn | 1538-7933 1538-7836 1538-7836 |
| language | eng |
| recordid | cdi_hal_primary_oai_HAL_hal_03800679v1 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Aged Anticoagulants Anticoagulants - therapeutic use Blood groups Blood pressure Chronic Disease clinical studies Diagnosis Embolism Humans Hypertension Hypertension, Pulmonary - complications Hypertension, Pulmonary - diagnosis Hypertension, Pulmonary - epidemiology incidence Life Sciences pulmonary embolism Pulmonary Embolism - complications Pulmonary Embolism - diagnosis Pulmonary Embolism - epidemiology Pulmonary embolisms Pulmonary hypertension Risk Factors Thromboembolism Vitamin K |
| title | Frequency and predictors for chronic thromboembolic pulmonary hypertension after a first unprovoked pulmonary embolism: Results from PADIS studies |
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