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Incidence of chronic thromboembolic pulmonary hypertension after severe forms of acute pulmonary embolism: systematic review with meta-analysis
Session:
SESSÃO DE POSTERS 13 - CONGÉNITOS E HTP 1
Speaker:
Rita Calé
Congress:
CPC 2025
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
Subtheme:
21.2 Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Cartazes
FP Number:
---
Authors:
Rita Calé; Mariana Martinho; Filipa Ferreira; Sofia Alegria; João Luz; Hélder Pereira; Daniel Caldeira
Abstract
<p style="text-align:start"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong>Introduction</strong></span></span></span></p> <p style="text-align:start"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000">The incidence of chronic thromboembolic pulmonary hypertension (CTEPH) after severe forms of pulmonary embolism (PE) is currently unknown and could be clinically relevant.</span></span></span></p> <p style="text-align:start"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong>Aim</strong><br /> This meta-analysis aimed to estimate the proportion of CTEPH diagnosed following intermediate- or high-risk acute PE and assess the impact of differing diagnostic methods on reported proportions.</span></span></span></p> <p style="text-align:start"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong>Methods</strong><br /> Eligible studies were identified through a systematic search of MEDLINE and Cochrane Central Register of Controlled Trials (CENTRAL) databases in March 2024. Inclusion criteria encompassed studies reporting CTEPH outcomes, confirmed either by right heart catheterization (RHC) or in which the diagnosis of CTEPH was based on other diagnostic criteria (clinical/echocardiography and ventilation/perfusion lung scintigraphy, with or without RHC confirmation) following intermediate- or high-risk acute PE. The pooled prevalence with the respective 95 % confidence interval (CI) was derived by random effects meta-analysis. Heterogeneity was assessed using the I2 metric.</span></span></span></p> <p style="text-align:start"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong>Results</strong><br /> A total of 13 studies (n = 50,109) were included. The median follow-up duration was 26.1 months (IQR: 8.3-38.7). CTEPH confirmed by RHC was reported in 4.31% of patients (95% CI: 1.29–8.76; I² = 97%; figure 1A), while CTEPH assessed by other non-invasive tests than RHC was reported in 6.47% (95% CI: 3.04–10.93; I² = 75.55%; figure 1B). Significant variability in the diagnostic approaches, in study design and follow-up periods contributed to the observed statistical heterogeneity.</span></span></span></p> <p style="text-align:start"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong>Conclusions</strong><br /> CTEPH was diagnosed in about one for every 20 patients that had intermediate- or high-risk acute PE. The findings underscore the importance of systematic follow-up in delivering tailored management strategies, with the aim of improving patient outcomes and mitigating long-term complications in a significant proportion of these patients.</span></span></span></p> <p style="text-align:start"> </p> <p style="text-align:start"> </p>
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