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A Prediction Rule for Occurrence of Chronic Thromboembolic Disease After Acute Pulmonary Embolism

Wei Xiong1, He Du2, Yong Luo3

  • 1Department of Pulmonary and Critical Care Medicine, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Heart, Lung & Circulation
|June 14, 2024
PubMed

Insights

A new Prediction Rule for CTED (PRC) score helps predict chronic thromboembolic disease (CTED) after acute pulmonary embolism (PE) treatment. This tool aids in identifying patients at risk for CTED following anticoagulation therapy.

Area of Science:

  • Cardiology
  • Pulmonary Medicine
  • Clinical Prediction Models

Background:

  • Chronic thromboembolic disease (CTED) can occur despite standard anticoagulation for acute pulmonary embolism (PE).
  • No validated scoring system currently exists to predict CTED development post-PE treatment.

Purpose of the Study:

  • To develop and validate a prediction score for identifying patients at risk of CTED after acute PE.
  • To provide a tool for risk stratification in patients treated for acute PE.

Main Methods:

  • A Prediction Rule for CTED (PRC) score was developed in a cohort of 1,124 patients and validated in a separate cohort of 211 patients.
  • Both original and simplified versions of the PRC score were evaluated using various performance metrics.

Main Results:

  • The PRC score incorporates 10 risk factors including active cancer, autoimmune diseases, obesity, immobility, elevated D-dimer, PE with DVT, prior VTE, non-VTE thromboembolism, thrombophilia, and unprovoked VTE.
  • In validation, the original PRC score demonstrated high sensitivity (86.3%) and specificity (76.3%) with a C-index of 0.815, outperforming the DASH score.
  • The simplified PRC score also showed strong predictive performance, indicating its clinical utility.

Conclusions:

  • The developed Prediction Rule for CTED (PRC) score effectively predicts the likelihood of CTED occurrence.
  • The PRC score can aid clinicians in managing patients with acute PE by identifying those at higher risk for developing CTED.
Abstract

Keywords:
Acute pulmonary embolismChronic thromboembolic diseasePredictionScoreVenous thromboembolism

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