Medical conditions increasing the risk of chronic thromboembolic pulmonary hypertension.
Chronic thromboembolic pulmonary hypertension (CTEPH) is characterized by organized thromboemboli that obstruct the pulmonary vascular bed. Although CTEPH is a serious complication of acute symptomatic pulmonary embolism in 4% of cases, signs, symptoms and classical risk factors for venous thromboembolism are lacking. The aim of the present study was to identify medical conditions conferring an increased risk of CTEPH. We performed a case-control-study comparing 109 consecutive CTEPH patients to 187 patients with acute pulmonary embolism that was confirmed by a high probability lung scan. Splenectomy (odds ratio=13, 95% CI 2.7-127), ventriculo-atrial (VA-) shunt for the treatment of hydrocephalus (odds ratio=13, 95% CI 2.5-129) and chronic inflammatory disorders, such as osteomyelitis and inflammatory bowel disease (IBD, odds ratio=67, 95% CI 7.9-8832) were associated with an increased risk of CTEPH.
Bonderman
Diana
D
Medical University of Vienna, Department of Cardiology, Vienna, Austria.
Jakowitsch
Johannes
J
Adlbrecht
Christopher
C
Schemper
Michael
M
Kyrle
Paul A
PA
Schönauer
Verena
V
Exner
Markus
M
Klepetko
Walter
W
Kneussl
Meinhard P
MP
Maurer
Gerald
G
Lang
Irene
I
D000328:Adult; D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000628:therapy; D006976:Hypertension, Pulmonary / Q000209:etiology*; D007249:Inflammation / Q000150:complications / Q000503:physiopathology; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010019:Osteomyelitis / Q000150:complications / Q000503:physiopathology; D011655:Pulmonary Embolism; D012306:Risk; D013156:Splenectomy / Q000009:adverse effects; D013923:Thromboembolism