The incidence and related risk factors of chronic thromboembolic pulmonary hypertension in acute pulmonary embolism patients

More than half of (>%50) patients with CTEPH have no acute pulmonary embolism history with clinical signs, so determining of actual incidence and prevalence of CTEPH is difficult. At this study, we aimed to search the CTEPH incidence and the risk factors those may be associated with CTEPH in patients who had acute PTE. Three hundred twelve patients with acute pulmonary embolism diagnosed by Thorax CT or ventilation/perfussion scintigraphy in our clinic included into the study. Patients that have risk factors for pulmoner hypertension other than thromboembolic disease were excluded. Fiftyseven of 112 patients were female, and 55 of them were male, average age was 57.09±17.30 (16-86). Presence of PHT (systolic PAB>35 mmHg) was determined by echocardiography performed on 6th month in 45 of 112 patients (8 of them was sympthomatic) and CTEPH incidence (sympthomatic+asympthomatic) was identified as %40.16. Sympthomatic CTEPH incidence was calculated as %7.14. When we searched about risk factors that may have role in development of CTEPH; we determined that CTEPH risk was increased 4.59 times by being male sex (95% CI 1.071-19.683, p=0.040), 218 times by previous history of DVT (95% CI 1.235-38543.073, p=0.041), and 56.903 times by PaO2 <80 mmHg (95% CI 2.656-1219.228, p= 0.010). When we applied multiple logistic regression analysis on parameters that may be risk factors for CTEPH development, it was seen that female sex was determined as an independent risk factor for development of only CTEPH, in which sPAB values were between 36-49 mmHg (95% CI 1.417-43.139, p=0.018). In conclusion, CTEPH development after PTE is a situation that can occur in many patients. If probable risk factors is known, patients can be closely monitorize for CTEPH development. Keywords: PTE, CTEPH, incidence, risk factors