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

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

Pdf Summary

The United States Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Registry, led by the University of California at San Diego, provides insights into treatments for CTEPH, a rare disease emanating from pulmonary embolism. CTEPH's state-of-the-art treatment is pulmonary endarterectomy (PEA), an advanced surgical procedure to clear obstructed pulmonary artery branches. The registry covers data from 750 patients diagnosed within six months of enrollment across 30 U.S. centers. It details the baseline characteristics and 1-year outcomes differentiating operable from non-operable conditions. Operable cases identified specific patterns - younger age, history of deep vein thrombosis (DVT), and less likelihood of coexisting COPD or cancer.<br /><br />Kerr et al. highlighted that patients undergoing PEA achieved superior outcomes with a 3.9% 30-day mortality rate and 82.9% reaching New York Heart Association functional class 1 or 2 in one year. Meanwhile, the registry outlines the evolution of medical and surgical approaches, influenced by recent approvals of therapeutics like riociguat and treprostinil, and the refinement of balloon pulmonary angioplasty for non-surgical candidates.<br /><br />Contrasts in patient demographics and treatment frequencies between U.S., European, and Asian populations were also noted—more obesity in the U.S. versus Asia, and different prevalence of balloon pulmonary angioplasty use. The U.S. data had a surgical candidate bias, showcasing the prominence of PEA, which has significantly uplifted patients from severe conditions to near-normal states. The U.S. approach contrasts with other global registries; however, these findings offer a crucial benchmark for future treatment strategies and international comparisons. <br /><br />This registry’s results, coupled with advancements in treatment techniques, emphasize the continuously evolving landscape of managing CTEPH and underscore the critical role of surgical intervention as an optimal strategy.

Keywords

CTEPH Registry

pulmonary endarterectomy

chronic thromboembolic pulmonary hypertension

University of California San Diego

pulmonary embolism

balloon pulmonary angioplasty

New York Heart Association

riociguat

treprostinil

deep vein thrombosis