title: Long-term clinical course of acute pulmonary embolism.
abstract: The long-term clinical course of acute pulmonary embolism (PE) is complicated by high rates of serious adverse events, both before and after cessation of anticoagulant therapy. These adverse events include recurrent venous thromboembolism, chronic thromboembolic pulmonary hypertension, arterial thrombotic events and increased risk of death, all compared to patients without thromboembolic disease. Several pharmacological options are available that may beneficially influence patients' prognosis. Nonetheless, because of insufficient knowledge of the benefit-to-harm ratio of these pharmacological agents, unambiguous recommendations are scarcely available. This review will cover the epidemiological aspects of the various possible complications in the long-term clinical course of acute PE as well as the latest evidence on preventive strategies. In addition, the unresolved issues regarding frequency, duration and focus of medical follow-up after acute PE are discussed.
authors.affiliation: Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: P L
authors.initials: PL
authors.lastname: den Exter
authors.forename: T
authors.initials: T
authors.lastname: van der Hulle
authors.forename: M
authors.initials: M
authors.lastname: Lankeit
authors.forename: M V
authors.initials: MV
authors.lastname: Huisman
authors.forename: F A
authors.initials: FA
authors.lastname: Klok
mesh_terms: D000208:Acute Disease; D000925:Anticoagulants / Q000627:therapeutic use; D006801:Humans; D011379:Prognosis; D011655:Pulmonary Embolism / Q000188:drug therapy / Q000473:pathology*; D012307:Risk Factors
chemical_list: D000925:Anticoagulants
keywords: Arterial cardiovascular events; Aspirin; CTEPH; DOAC; Mortality; Recurrent pulmonary embolism; Statin; Vitamin K antagonists