Feasibility of a screening algorithm for chronic thromboembolic pulmonary hypertension : The OSIRIS study
Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved..
INTRODUCTION: 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.
MATERIAL AND METHODS: 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.
RESULTS: 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 %).
CONCLUSIONS: 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.
CLINICAL TRIAL REGISTRATION: clinicaltrials.gov identifier: NCT03134898.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:228 |
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| Enthalten in: |
Thrombosis research - 228(2023) vom: 15. Aug., Seite 1-9 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Otero, Remedios [VerfasserIn] |
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| Links: |
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| Themen: |
Chronic thromboembolic pulmonary hypertension |
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| Anmerkungen: |
Date Completed 03.07.2023 Date Revised 29.11.2023 published: Print-Electronic ClinicalTrials.gov: NCT03134898 Citation Status MEDLINE |
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| doi: |
10.1016/j.thromres.2023.05.005 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM357652029 |
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| 245 | 1 | 0 | |a Feasibility of a screening algorithm for chronic thromboembolic pulmonary hypertension |b The OSIRIS study |
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| 500 | |a Date Completed 03.07.2023 | ||
| 500 | |a Date Revised 29.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT03134898 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a INTRODUCTION: 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 | ||
| 520 | |a MATERIAL AND METHODS: 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 | ||
| 520 | |a RESULTS: 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 %) | ||
| 520 | |a CONCLUSIONS: 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 | ||
| 520 | |a CLINICAL TRIAL REGISTRATION: clinicaltrials.gov identifier: NCT03134898 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Chronic thromboembolic pulmonary hypertension | |
| 650 | 4 | |a Diagnosis | |
| 650 | 4 | |a Health decision making | |
| 650 | 4 | |a Incidence | |
| 650 | 4 | |a Pulmonary embolism | |
| 650 | 4 | |a Pulmonary hypertension | |
| 700 | 1 | |a Lobo, José Luis |e verfasserin |4 aut | |
| 700 | 1 | |a López, Raquel |e verfasserin |4 aut | |
| 700 | 1 | |a Fernández, Carmen |e verfasserin |4 aut | |
| 700 | 1 | |a Jiménez, David |e verfasserin |4 aut | |
| 700 | 1 | |a Muriel, Alfonso |e verfasserin |4 aut | |
| 700 | 1 | |a Alfonso, María |e verfasserin |4 aut | |
| 700 | 1 | |a Ballaz, Aitor |e verfasserin |4 aut | |
| 700 | 1 | |a Núñez-Ares, Ana |e verfasserin |4 aut | |
| 700 | 1 | |a Rodríguez-Matute, Consolación |e verfasserin |4 aut | |
| 700 | 1 | |a de Miguel-Díez, Javier |e verfasserin |4 aut | |
| 700 | 1 | |a Rodríguez-Chiaradía, Diego Agustín |e verfasserin |4 aut | |
| 700 | 1 | |a Alcalde, Mercedes |e verfasserin |4 aut | |
| 700 | 1 | |a Elías, Teresa |e verfasserin |4 aut | |
| 700 | 1 | |a Jara-Palomares, Luis |e verfasserin |4 aut | |
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| 700 | 1 | |a García-Ortega, Alberto |e verfasserin |4 aut | |
| 700 | 1 | |a Sancho, Teresa |e verfasserin |4 aut | |
| 700 | 1 | |a Morillo, Raquel |e verfasserin |4 aut | |
| 700 | 1 | |a García-Bragado, Fernando |e verfasserin |4 aut | |
| 700 | 1 | |a Hernández-Blasco, Luis |e verfasserin |4 aut | |
| 700 | 1 | |a Uresandi, Fernando |e verfasserin |4 aut | |
| 700 | 1 | |a Madridano, Olga |e verfasserin |4 aut | |
| 700 | 1 | |a Agüero, Ramón |e verfasserin |4 aut | |
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