CHEST Guidelines-Results-From-the-United-States-Chronic-Thromboembo

Results-From-the-United-States-Chronic-Thromboembo_49

Pdf Summary

The United States Chronic Thromboembolic Pulmonary Hypertension Registry (US-CTEPH-R) investigated the demographic characteristics, clinical evaluations, and outcomes of patients with Chronic Thromboembolic Pulmonary Hypertension (CTEPH) over one year. Between 2015 and 2018, 750 patients were enrolled in this multicenter, prospective registry involving 30 sites, coordinated by the University of California San Diego.

Key findings from the registry include:
1. <strong>Patient Characteristics</strong>: Most CTEPH patients had a history of acute pulmonary embolism (87.9%), with a median delay of 10 months from symptom onset to diagnosis. Operable patients undergoing pulmonary thromboendarterectomy (PTE) surgery were younger and had fewer comorbidities compared to inoperable ones.
   
2. <strong>Surgical and Medical Outcomes</strong>: Of the 750 patients, 566 underwent PTE, resulting in a reduced pulmonary vascular resistance and a 3.9% in-hospital mortality. At the one-year follow-up, those who underwent surgery showed better health outcomes, evidenced by improved World Health Organization functional class and decreased need for oxygen, diuretics, or pulmonary hypertension-targeted therapy compared to non-operated patients.

3. <strong>Differences Between Operability</strong>: Inoperable patients were generally older and had more comorbidities like COPD and cancer. At enrollment, these patients presented more advanced disease stages and had a higher prevalence of distal disease.

4. <strong>Registry Significance</strong>: This registry is the first of its kind in the US and offers detailed contemporary insights into CTEPH patient profiles, management strategies, and outcomes, emphasizing the efficacy of PTE surgery in eligible patients and highlighting the diagnostic delays often encountered.

The study underscores the importance of timely diagnosis and treatment of CTEPH and supports surgical intervention when feasible, showcasing positive results in terms of survival and quality of life improvements.

Keywords

Chronic Thromboembolic Pulmonary Hypertension

CTEPH

US-CTEPH-R

pulmonary thromboendarterectomy

PTE surgery

pulmonary embolism

registry

patient outcomes

diagnostic delays

University of California San Diego