ClotCare: Blood Clots, Stroke, Heart Attack
Sunday, April 23, 2017
Home   |   DVT/PE   |   Blood Clots   |   Coumadin/Warfarin   |   New Patients   |   Self Testing   |   Email List   |   Donate

Pick a Topic:

Find info on a:

We subscribe to the HONcode principles of the HON Foundation. Click to verify.
ClotCare complies with the HONcode standard for trustworthy health
information:
verify here.

ClotCare is a member of the Coalition to Prevent Deep Vein Thrombosis (DVT Coalition)  ClotCare is a member organization of the Coalition to Prevent Deep Vein Thrombosis. Click here to learn more about the Coalition to Prevent Deep Vein Thrombosis and DVT Awareness Month, which is held each March.

Pulmonary Hypertension After PE More Common Than Previously Thought

Jason Cota, Pharm.D. Student at the University of Texas at Austin
Henry I. Bussey, Pharm.D.
October 2004

A recent study and accompanying editorial found that chronic thromboembolic pulmonary hypertension (CTHP) occurs in more than 3% of patients with pulmonary embolism (PE). Further, risk factors for CTHP appear to be younger age, previous PE, idiopathic cause, and size of PE.

The Study

This prospective, long-term follow-up study evaluated 223 patients presenting with an acute PE without previous thromboembolic events in order to estimate the incidence of chronic thromboembolic pulmonary hypertension (CTPH). Investigators diagnosed CTPH in 7 of 223 patients (3.1%) with a mean time from qualifying PE to CTPH diagnosis of 9 months (range of 3 to 21 months). Kaplan-Meier analysis showed the cumulative incidence of CTPH was 3.8% at 2 years.

For risk factor analysis, the investigators also included an additional 82 PE patients who had a history of previous PE or DVT for a total of 305 patients. Of these 305, 18 patients (5.9%) developed CTPH and the 287 patients who did not develop CTPH were termed control patients. The mean age of the CTPH group was 48.6 years compared to 62 years in the control group. Previous PE was identified in 8 of 18 CTPH patients (44.4%) as compared to 16 of 287 (5.6%) control patients. Ten patients in the CTPH group (55.6%) presented with idiopathic PE compared to 55 (19.2%) of the controls. Finally, mean perfusion defect in CTPH group was 62.6% compared to 33.7% in the control group. These patient characteristics were identified as risk factors for CTPH.

The Editorial

Lang points out that the 3.8% incidence of CTPH at 2 years actually may be higher because the initial thromboembolic event in CTPH can be asymptomatic in most patients. Although the presence of lupus anticoagulant, anticardiolipin antibodies or elevated factor VIII levels (termed "permanent risk factors" in the study) were not identified as risk factors for CTPH, 55.6% of CTPH patients had an idiopathic PE and may have had these underlying abnormalities. The authors conclude that CTPH following PE is relatively common and perhaps recognizing those patients at risk, in addition to achieving better anticoagulation, would prevent the development of CTPH.

References

1. Pengo V, Lensing AW, Prins MH, et al. Incidence of Chronic Thromboembolic Pulmonary Hypertension after Pulmonary Embolism. New England Journal of Medicine 2004; 350:2257-2264.

2. (accompanying editorial): Lang IM. Chronic thromboembolic pulmonary hypertension--Not so rare after all. New England Journal of Medicine 2004; 350:2236-38

Ask a question about blood clots or anticoagulant medications Have questions? Ask ClotCare. Send questions by email to webmaster@clotcare.org.

ClotCare is a 501(c)(3) non-profit organization generously supported by your tax-deductible donations and grants from our industry supporters.

Blood Clot Activities Calendar

New Postings:

An Update on Testosterone Supplementation and Venous Thrombosis by Charles J. Glueck, M.D.

Seeking Patients Taking Warfarin (Coumadin) for a Brief Survey

Click here to view full list of new postings
ClotCare Home | New Postings | Patient Postings | Clinician Postings | Join Our Email List | Useful Web Links
CE Opportunities | Training Programs | DVT & PE Stories | Editorial Board | Financial Support
About ClotCare | DVT Coalition | Donate to ClotCare | Contact Us
Key topics discussed on ClotCare include: Blood Clots | Deep Vein Thrombosis (DVT) | Pulmonary Embolism (PE) | Atrial Fibrillation (A. Fib or AF) | Heart Attack | Stroke | Transient Ischemic Attack (TIA) | Mini Stroke | Bleeding Complications | Vascular Surgery | Surgical Blood Clot Removal | Warfarin | Coumadin | Lovenox | Low Molecular Weight Heparin (LMWH) | Heparin | Anticoagulants | Plavix | Aspirin | Antiplatelets | Blood Thinners
Copyright 2000-2014 by ClotCare. All rights reserved.
Terms, Conditions, & Privacy | Image Copyright Information
19260 Stone Oak Parkway, Suite 101 | San Antonio, TX 78258 | 210-495-4335
Send comments to webmaster@clotcare.org.
Sunday, April 23, 2017