Details

Autor(en) / Beteiligte

• Otero, Remedios
• Lobo, José Luis
• López, Raquel
• Fernández, Carmen
• Jiménez, David
• Muriel, Alfonso
• Alfonso, María
• Ballaz, Aitor
• Núñez-Ares, Ana
• Rodríguez-Matute, Consolación
• de Miguel-Díez, Javier
• Rodríguez-Chiaradía, Diego Agustín
• Alcalde, Mercedes
• Elías, Teresa
• Jara-Palomares, Luis
• Rivas, Agustina
• Alonso, Ángel
• García-Ortega, Alberto
• Sancho, Teresa
• Morillo, Raquel
• García-Bragado, Fernando
• Hernández-Blasco, Luis
• Uresandi, Fernando
• Madridano, Olga
• Agüero, Ramón
• Monreal, Manuel

Titel

Feasibility of a screening algorithm for chronic thromboembolic pulmonary hypertension: The OSIRIS study

Ist Teil von

• Thrombosis research, 2023-08, Vol.228, p.1-9

Ort / Verlag

United States: Elsevier Ltd

Erscheinungsjahr

2023

Quelle

MEDLINE

Beschreibungen/Notizen

• Chronic thromboembolic pulmonary hypertension (CTEPH) is a long-term sequel to pulmonary embolism (PE) whose incidence varies according to different published studies. We have carried out this study to determine its incidence within 2 years after index pulmonary embolism and to study limitations to an early diagnosis. OSIRIS is a multicentre, longitudinal cohort study. Patients were followed for 3, 6, 12, and 24 months after pulmonary embolism using a structured three-step algorithm. A physician-centered questionnaire at least one positive response in a screening proceeded to the second step, transthoracic echocardiography. The third step consisted of ventilation/perfusion lung scintigraphy and right heart catheterisation. A transthoracic echocardiography was performed in patients without positive response in the screening questionnaire after 2 years. CTEPH diagnosis required haemodynamic confirmation by right heart catheterisation and mismatched perfusion defects on lung scintigraphy. A total of 1191 patients were enrolled in 18 Spanish hospitals. Cumulative CTEPH incidence after 2-years PE was: 2.49 % (95 % CI: 1.68–3.56) and the incidence rate of CTEPH was 1.1 cases per 1000 person-months (95 % CI: 0.725; 1.60). The CTEPH algorithm presented a lack of adherence of 29 %; patient and physician preferences posed barriers to the triage algorithm The screening questionnaire, in patients who completed the follow-up, shows a specificity of 91.3 % (89.0–93.2 %) and negative predictive value of 99.4 % (98.4–99.8 %).. OSIRIS provides practiced clinical based data on the chronic thromboembolic pulmonary hypertension incidence and identified barriers to the implementation of a 3-step triage algorithm for its detection. clinicaltrials.gov identifier: NCT03134898. [Display omitted] •Two-year cumulative incidence of Chronic Thromboembolic Pulmonary Hypertension (CTEPH) after pulmonary embolism (PE) was 2.49% (95% CI: 1.68-3.56)•A structured three-step diagnostic algorithm based on clinical assessment starting with a screening questionnaire showed limited feasibility, but a high negative predictive value•Observed barriers from patients and physicians to the implementation of a screening-based CTEPH diagnostic algorithm may support the planning of future studies and help to address training gaps