A recent study, published in the journal Pulmonary Circulation, estimated the incidence and mortality of chronic thromboembolic pulmonary hypertension (CTEPH) in a cohort of patients with first venous thromboembolism (VTE). Study reports that CTEPH developed more commonly after pulmonary embolism (PE) and less frequently after deep vein thrombosis (DVT).
Researchers used data from the subset of the UK Clinical Practice Research Datalink to identify 23,329 patients (aged, <85 years) with first VTE and no active cancer in England. A clinical-guideline based algorithm assessed CTEPH while a nested case- control analysis ascertained risk factors for CTEPH.
In 81,413 person-years of follow-up, 283 patients were diagnosed with CTEPH (incidence rate, 3.5 [95% CI, 3.1-3.9]/1000 person-years). On stratifying by VTE type, the incidence rate was 1.6 (95% CI, 1.3-2.0)/1000 person-years following a DVT and 5.6 (95% CI, 4.9-6.4)/1000 person-years following a PE. Age >70 years (aOR, 2.04; 95% CI, 1.23-3.38), female sex (aOR, 1.44; 95% CI, 1.06-1.94), PE at first VTE with/without DVT (aOR, 3.11; 95% CI, 2.23-4.35), subsequent PE with/without DVT (aOR, 3.17; 95% CI, 2.02-4.96), only DVT (aOR, 2.46; 95% CI, 1.34-4.51), COPD (aOR, 3.17; 95% CI, 2.13-4.73), heart failure (aOR, 2.52; 95% CI, 1.76-3.63) and Afib (aOR, 2.42; 95% CI, 1.71-3.42) were risk factors for CTEPH.
Authors emphasise that awareness of risk factors is important for increased referrals to specialised centres for confirmation of CTEPH and initiation of specific treatment.
