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Observational Study
. 2018 Apr 4;51(4):1702505.
doi: 10.1183/13993003.02505-2017. Print 2018 Apr.

Multicentre observational screening survey for the detection of CTEPH following pulmonary embolism

Nicolas Coquoz  1   2 , Daniel Weilenmann  3 , Daiana Stolz  4 , Vladimir Popov  5 , Andrea Azzola  6 , Jean-Marc Fellrath  7 , Hans Stricker  8 , Alberto Pagnamenta  9 , Sebastian Ott  10 , Silvia Ulrich  11 , Sandor Györik  12 , Jérôme Pasquier  13 , John-David Aubert  1   2   14
Affiliations
Free article
Observational Study

Multicentre observational screening survey for the detection of CTEPH following pulmonary embolism

Nicolas Coquoz et al. Eur Respir J. .
Free article

Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) is a severe complication of pulmonary embolism. Its incidence following pulmonary embolism is debated. Active screening for CTEPH in patients with acute pulmonary embolism is yet to be recommended.This prospective, multicentre, observational study (Multicentre Observational Screening Survey for the Detection of Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Following Pulmonary Embolism (INPUT on PE); ISRCTN61417303) included patients with acute pulmonary embolism from 11 centres in Switzerland from March 2009 to November 2016. Screening for possible CTEPH was performed at 6, 12 and 24 months using a stepwise algorithm that included a dyspnoea phone-based survey, transthoracic echocardiography, right heart catheterisation and radiological confirmation of CTEPH.Out of 1699 patients with pulmonary embolism, 508 patients were assessed for CTEPH screening over 2 years. CTEPH incidence following pulmonary embolism was 3.7 per 1000 patient-years, with a 2-year cumulative incidence of 0.79%. The Swiss pulmonary hypertension registry consulted in December 2016 did not report additional CTEPH cases in these patients. The survey yielded 100% sensitivity and 81.6% specificity. The second step echocardiography in newly dyspnoeic patients showed a negative predictive value of 100%.CTEPH is a rare but treatable disease. A simple and sensitive way for CTEPH screening in patients with acute pulmonary embolism is recommended.

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Conflict of interest statement

Conflict of interest: N. Coquoz received travel support for the international CTEPH conference 2017 (Leuven) from MSD Switzerland, and grants from Swiss society for pulmonary hypertension, during the conduct of the study. Conflict of interest: S. Ulrich has received grants from the Swiss National Science Foundation, Zurich Lung and Orpha Swiss, grants and personal fees from Actelion SA, Switzerland, and personal fees from MSD SA, Switzerland, outside the submitted work. Conflict of interest: J-D. Aubert received grants from the Swiss Society for Pulmonary Hypertension, during the conduct of the study; and personal fees from Bayer and Actelion Switzerland for advisory board participation, and travel expenses from Actelion Switzerland, outside the submitted work.

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