Symptom-related screening programme for early detection of chronic thromboembolic pulmonary hypertension after acute pulmonary embolism: the SYSPPE study
Por:
Marin-Romero, Samira, Ballaz-Quincoces, Aitor, Gomez-Cuervo, Covadonga, Marchena P, Lopez-Miguel, Patricia, Francisco-Albesa, Iria, Pedrajas-Navas, Jose Maria, Lumbierres, Marina, Aibar-Arregui, Miguel Angel, Bosco Lopez-Saez, Juan, Perez-Pinar, Montserrat, Baeza-Martinez, Carlos, Riera-Mestre, Antoni, Peris-Sifre, Marisa, Porras-Ledantes, Jose Antonio, Criado-Garcia, Juan, Elias-Hernandez, Teresa, Otero, Remedios, Barca-Hernando, Maria, Muriel, Alfonso, Klok, Frederikus A. and Jara-Palomares, Luis
Publicada:
1 feb 2024
Ahead of Print:
1 dic 2023
Resumen:
BackgroundChronic thromboembolic pulmonary hypertension (CTEPH) is the most severe long-term complication of acute pulmonary embolism (PE). We aimed to evaluate the impact of a symptom screening programme to detect CTEPH in PE survivors.MethodsThis was a multicentre cohort study of patients diagnosed with acute symptomatic PE between January 2017 and December 2018 in 16 centres in Spain. Patients were contacted by phone 2 years after the index PE diagnosis. Those with dyspnoea corresponding to a New York Heart Association (NYHA)/WHO scale >= II, visited the outpatient clinic for echocardiography and further diagnostic tests including right heart catheterisation (RHC). The primary outcome was the new diagnosis of CTEPH confirmed by RHC.ResultsOut of 1077 patients with acute PE, 646 were included in the symptom screening. At 2 years, 21.8% (n=141) reported dyspnoea NYHA/WHO scale >= II. Before symptom screening protocol, five patients were diagnosed with CTEPH following routine care. In patients with NYHA/WHO scale >= II, after symptom screening protocol, the echocardiographic probability of pulmonary hypertension (PH) was low, intermediate and high in 76.6% (n=95), 21.8% (n=27) and 1.6% (n=2), respectively. After performing additional diagnostic test in the latter 2 groups, 12 additional CTEPH cases were confirmed.ConclusionsThe implementation of this simple strategy based on symptom evaluation by phone diagnosed more than doubled the number of CTEPH cases. Dedicated follow-up algorithms for PE survivors help diagnosing CTEPH earlier.Trial registration numberNCT03953560.
Filiaciones:
Virgen Rocio Univ Hosp, Resp Unit, Med Surg Unit Resp Dis, Seville
41013, Spain
Virgen Rocio Univ Hosp, Resp Unit, Med Surg Unit Resp Dis, Seville,
Spain
Hosp Galdakao Usansolo, Resp Unit, Galdakao, Spain
Hosp Univ Doce Octubre, Internal Med, Madrid, Spain
St Joan Deu Hosp, Internal Med Unit, Barcelona, Spain
Albacete Univ Hosp Complex, Resp Unit, Albacete, Spain
Doctor Josep Trueta Univ Hosp, Internal Med Unit, Girona, Spain
San Carlos Clin Hosp, Internal Med Unit, Madrid, Spain
Arnau de Vilanova Univ Hosp, Resp Dept, Lleida, Spain
Lozano Blesa Univ Clin Hosp, Internal Med Unit, Zaragoza, Spain
Univ Hosp Puerto Real, Internal Med Unit, Puerto Real, Spain
Virgen Luz Hosp, Internal Med Unit, Cuenca, Spain
Hosp Gen Univ Elche, Resp Unit, Elche, Spain
Bellvitge Univ Hosp, Internal Med, LHospitalet De Llobregat, Spain
Inst Invest Biomed Bellvitge, Barcelona, Spain
Univ Barcelona, Fac Med & Ciencias Salud, Dept Ciencias Clin, Barcelona,
Hosp Prov Castellon, Internal Med Unit, Castellon De La Plana, Spain
CEU Cardenal Herrera Univ, Moncada, Spain
Joan XXIII Univ Hosp, Internal Med Unit, Tarragona, Spain
Reina Sofia Univ Hosp, Internal Med Unit, Cordoba, Spain
Carlos III Hlth Inst, Ctr Biomed Res Resp Dis Network CIBERES, Madrid,
Hosp Univ Ramon y Cajal, Biostat Dept, Madrid, Spain
Univ Alcala, Alcala De Henares, Spain
Leiden Univ, Dept Med Thrombosis & Hemostasis, Med Ctr, Leiden,
Netherlands
Green Submitted, hybrid
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