Valerio, Luca ORCID: 0000-0003-4466-0724, Mavromanoli, Anna C., Barco, Stefano ORCID: 0000-0002-2618-347X, Abele, Christina ORCID: 0000-0002-1991-0587, Becker, Dorothea, Bruch, Leonhard, Ewert, Ralf, Faehling, Martin, Fistera, David, Gerhardt, Felix, Ghofrani, Hossein-Ardeschir, Grgic, Aleksandar, Gruenig, Ekkehard, Halank, Michael, Held, Matthias, Hobohm, Lukas, Hoeper, Marius M., Klok, Frederikus A., Lankeit, Mareike, Leuchte, Hanno H., Martin, Nadine, Mayer, Eckhard, Meyer, F. Joachim, Neurohr, Claus, Opitz, Christian, Schmidt, Kai-Helge, Seyfarth, Hans-Jurgen, Wachter, Rolf, Wilkens, Heinrike, Wild, Philipp S., Konstantinides, Stavros, V and Rosenkranz, Stephan (2022). Chronic thromboembolic pulmonary hypertension and impairment after pulmonary embolism: the FOCUS study. Eur. Heart J., 43 (36). S. 3387 - 3399. OXFORD: OXFORD UNIV PRESS. ISSN 1522-9645

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Abstract

Aims To systematically assess late outcomes of acute pulmonary embolism (PE) and to investigate the clinical implications of post-PE impairment (PPEI) fulfilling prospectively defined criteria. Methods and results A prospective multicentre observational cohort study was conducted in 17 large-volume centres across Germany. Adult consecutive patients with confirmed acute symptomatic PE were followed with a standardized assessment plan and pre-defined visits at 3, 12, and 24 months. The co-primary outcomes were (i) diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH), and (ii) PPEI, a combination of persistent or worsening clinical, functional, biochemical, and imaging parameters during follow-up. A total of 1017 patients (45% women, median age 64 years) were included in the primary analysis. They were followed for a median duration of 732 days after PE diagnosis. The CTEPH was diagnosed in 16 (1.6%) patients, after a median of 129 days; the estimated 2-year cumulative incidence was 2.3% (1.2-4.4%). Overall, 880 patients were evaluable for PPEI; the 2-year cumulative incidence was 16.0% (95% confidence interval 12.8-20.8%). The PPEI helped to identify 15 of the 16 patients diagnosed with CTEPH during follow-up (hazard ratio for CTEPH vs. no CTEPH 393; 95% confidence interval 73-2119). Patients with PPEI had a higher risk of re-hospitalization and death as well as worse quality of life compared with those without PPEI. Conclusion In this prospective study, the cumulative 2-year incidence of CTEPH was 2.3%, but PPEI diagnosed by standardized criteria was frequent. Our findings support systematic follow-up of patients after acute PE and may help to optimize guideline recommendations and algorithms for post-PE care.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Valerio, LucaUNSPECIFIEDorcid.org/0000-0003-4466-0724UNSPECIFIED
Mavromanoli, Anna C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Barco, StefanoUNSPECIFIEDorcid.org/0000-0002-2618-347XUNSPECIFIED
Abele, ChristinaUNSPECIFIEDorcid.org/0000-0002-1991-0587UNSPECIFIED
Becker, DorotheaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bruch, LeonhardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ewert, RalfUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Faehling, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fistera, DavidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gerhardt, FelixUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ghofrani, Hossein-ArdeschirUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grgic, AleksandarUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gruenig, EkkehardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Halank, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Held, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hobohm, LukasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoeper, Marius M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klok, Frederikus A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lankeit, MareikeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Leuchte, Hanno H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Martin, NadineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mayer, EckhardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meyer, F. JoachimUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Neurohr, ClausUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Opitz, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmidt, Kai-HelgeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Seyfarth, Hans-JurgenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wachter, RolfUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wilkens, HeinrikeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wild, Philipp S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Konstantinides, Stavros, VUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rosenkranz, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-697495
DOI: 10.1093/eurheartj/ehac206
Journal or Publication Title: Eur. Heart J.
Volume: 43
Number: 36
Page Range: S. 3387 - 3399
Date: 2022
Publisher: OXFORD UNIV PRESS
Place of Publication: OXFORD
ISSN: 1522-9645
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
QUALITY-OF-LIFE; EUROPEAN-SOCIETY; RISK-FACTORS; GUIDELINES; VALIDATION; PREDICTION; MANAGEMENT; DIAGNOSIS; OUTCOMES; ESCMultiple languages
Cardiac & Cardiovascular SystemsMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69749

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