PB0918 - Outcomes of chronic thromboembolic pulmonary hypertension with or without prior venous thromboembolism

Monday, June 24, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

Dieuwke Luijten, MD, PhD cadidate

Department of Medicine - Thrombosis & Hemostasis, Leiden University Medical Center
Leiden, Zuid-Holland, Netherlands

Co-Author(s)

Erik Klok, MD, PhD, FESC

Leiden University Medical Center
EV

Emese Vágó

PhD
Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
Aarhus, Hovedstaden, Denmark
EH

Erzsébet Horváth-Puhó

MSc, PhD
Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
Aarhus, Hovedstaden, Denmark
Stefano Barco

MD, PhD
Clinic of Angiology, University Hospital Zurich, Zurich, Switzerland
Zurich, Zurich, Switzerland
HB

Hans Erik Bøtker

prof
Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
Aarhus, Hovedstaden, Denmark
KB

Kasper Bonnesen

MD, PhD
Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
Aarhus, Hovedstaden, Denmark
AV

Anton Vonk Noordegraaf

MD, PhD, prof
Department of Pulmonary Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
Amsterdam, Noord-Holland, Netherlands
MD

Marion Delcroix

MD, PhD, prof
Department of Pneumology, University Hospitals Leuven, Leuven, Belgium
Leuven, Vlaams-Brabant, Belgium
SK

Stavros Konstantinides

MD, PhD, prof
Center for Thrombosis and Hemostasis (CTH), University Medical Centre of the Johannes Gutenberg University, Mainz, Germany.
Mainz, Rheinland-Pfalz, Germany
Suzanne C. Cannegieter

MD, PhD, prof
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
Leiden, Zuid-Holland, Netherlands
HS

Henrik Toft Sørensen

MD, PhD, prof
Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
Aarhus, Hovedstaden, Denmark

Background: A considerable number of patients with chronic thromboembolic pulmonary hypertension (CTEPH) lack a history venous thromboembolism (VTE). The prognosis and pathophysiology may be different from those with prior VTE.

Aims: We set out to examine the annual incidence rate and prevalence of CTEPH in Denmark, and to evaluate rates of incident VTE, bleeding, and death in patients with CTEPH with versus without a prior VTE.

Methods: The Danish National Patient Registry (DNPR), totaling 6 674 147 individuals, was used to identify all CTEPH cases between 2009 and 2018, based on ICD-10 codes for CTEPH in combination with performed diagnostic and therapeutic interventions. Incidence rates of CTEPH were calculated as the number of incident patients with CTEPH per total Danish population person-years and reported per 100 000 person-years. VTE and bleeding outcomes were assessed starting from a 90 days landmark period after CTPEH diagnosis.

Results: 509 patients with CTEPH were identified; 82% had a prior history of VTE. The yearly incidence rate of CTEPH in Denmark ranged between 0.5 and 0.8 per 100 000 person-years. Compared to CTEPH patients without prior VTE, CTEPH patients with prior VTE exhibited a 2.5-fold increased rate of VTE (2571 versus 980 per 100 000 person-years, respectively), but a 0.70-fold decreased incidence rate of bleeding (5008 versus 7139 per 100 000 person-years, respectively). Overall, the 5-year survival was better in CTEPH patients with prior VTE (5-year survival rate 0.65, 95%CI 0.58–0.71) than in CTEPH patients without prior VTE (5-year survival rate 0.45, 95%CI 0.31–0.58; Figure 1).

Conclusion(s): We identified notable differences in the long-term prognosis of patients with CTEPH with or without prior VTE. These findings may support generation of hypotheses regarding the pathophysiology of CTEPH and inform current patient care.