title: Monitoring for Pulmonary Hypertension Following Pulmonary Embolism: The INFORM Study.
abstract: Pulmonary hypertension and chronic thromboembolic pulmonary hypertension may develop after a pulmonary embolism event. A ventilation-perfusion scan is recommended as a first-line modality for suspected chronic thromboembolic pulmonary hypertension. In this study, we determined the prevalence of pulmonary hypertension following incident pulmonary embolism and the disease-monitoring patterns in this population.
  
  
  
  We conducted a retrospective claims database analysis of incident pulmonary embolism cases (July 1, 2010 to September 30, 2011) and extracted data for 1 year prior to and 2 years after the incident pulmonary embolism event. Data were analyzed for diagnoses and symptoms related to pulmonary hypertension, claims consistent with other heart or lung diseases, diagnostic imaging tests, and time to first diagnostic imaging test post pulmonary embolism.
  
  
  
  Of the 7068 incident pulmonary embolism patients that met eligibility criteria, 87% had a claim for a pulmonary hypertension-related symptom and 7.6% had a claim for pulmonary hypertension during follow-up. Only 55% of all pulmonary embolism patients had diagnostic procedural claim(s) post pulmonary embolism: echocardiogram, 47%; computed tomographic angiography, 20%; ventilation-perfusion scan, 6%; and right heart catheterization or pulmonary angiography, <1%. The mean time from pulmonary embolism diagnosis to first screening test was 131 days.
  
  
  
  Despite exhibiting pulmonary hypertension-related symptoms, many pulmonary embolism patients did not undergo imaging tests that could diagnose pulmonary hypertension or chronic thromboembolic pulmonary hypertension. This study suggests that physician education about the risk of pulmonary hypertension and chronic thromboembolic pulmonary hypertension after pulmonary embolism may need to be improved.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Cedars-Sinai Medical Center, Los Angeles, Calif. Electronic address: victor.tapson@cshs.org.
authors.forename: Victor F
authors.initials: VF
authors.lastname: Tapson
authors.affiliation: Bayer HealthCare Pharmaceuticals, Whippany, NJ.
authors.forename: David M
authors.initials: DM
authors.lastname: Platt
authors.affiliation: Bayer HealthCare Pharmaceuticals, Whippany, NJ.
authors.forename: Fang
authors.initials: F
authors.lastname: Xia
authors.affiliation: Bayer Pharma AG, Berlin, Germany.
authors.forename: Simon A
authors.initials: SA
authors.lastname: Teal
authors.affiliation: Bayer Pharma AG, Berlin, Germany.
authors.forename: Margarita
authors.initials: M
authors.lastname: de la Orden
authors.affiliation: Bayer HealthCare Pharmaceuticals, Whippany, NJ.
authors.forename: Christine H
authors.initials: CH
authors.lastname: Divers
authors.affiliation: Bayer HealthCare Pharmaceuticals, Whippany, NJ.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Satler
authors.affiliation: Bayer HealthCare Pharmaceuticals, Whippany, NJ.
authors.forename: Vijay N
authors.initials: VN
authors.lastname: Joish
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston.
authors.forename: Richard N
authors.initials: RN
authors.lastname: Channick
mesh_terms: D000792:Angiography; D006328:Cardiac Catheterization; D004452:Echocardiography; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011655:Pulmonary Embolism / Q000150:complications*; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
keywords: CTEPH; Chronic thromboembolic pulmonary hypertension; Pulmonary embolism; Pulmonary hypertension; VQ scan