Department of Medicine - Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands; Center for Thrombosis and Haemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark.
J Thromb Haemost. 2024 Dec;22(12):3562-3571. doi: 10.1016/j.jtha.2024.09.006. Epub 2024 Sep 19.
A considerable number of patients with chronic thromboembolic pulmonary hypertension (CTEPH) lack a history of venous thromboembolism (VTE).
We aimed to examine the annual incidence and prevalence of CTEPH in Denmark and to compare the rates of VTE, bleeding, and mortality between CTEPH patients with and without a history of VTE.
The Danish National Patient Registry covering all Danish hospitals was used to identify all CTEPH cases between 2009 and 2018, based on combinations of discharge diagnoses using International Classification of Diseases, 10th Revision codes for CTEPH and relevant diagnostic and/or therapeutic interventions. Incidence rates of CTEPH per 100 000 person-years, rates of VTE and bleeding, and 5-year survival estimates were calculated.
In total, 509 CTEPH patients were identified, of whom 82% had a history of VTE. The yearly incidence rate of CTEPH was 0.5 to 0.8 per 100 000 person-years during the study period. Patients with a history of VTE experienced a 2.5-fold rate of VTE compared with those without prior VTE (2571 vs 980 per 100 000 person-years), while the rate of bleeding events was lower (5008 vs 7139 per 100 000 person-years). The 5-year survival of CTEPH patients with a VTE history was 65% (95% CI, 58%-71%) compared with 45% (95% CI, 31%-58%) in patients without a history of VTE.
The Danish incidence rate of CTEPH was comparable with that of other European countries. We identified notable differences in the prognosis of patients with CTEPH with or without a history of VTE. These findings may support generation of hypotheses regarding the pathophysiology of CTEPH and inform current patient care.
相当数量的慢性血栓栓塞性肺动脉高压（CTEPH）患者无静脉血栓栓塞（VTE）病史。
我们旨在研究丹麦 CTEPH 的年发病率和患病率，并比较有和无 VTE 病史的 CTEPH 患者的 VTE、出血和死亡率。
使用丹麦国家患者登记处，该登记处涵盖了所有丹麦医院，根据 CTEPH 和相关诊断和/或治疗干预的国际疾病分类，第 10 版代码的出院诊断组合，确定了 2009 年至 2018 年期间的所有 CTEPH 病例。计算了每 10 万人年 CTEPH 的发病率、VTE 和出血的发生率以及 5 年生存率。
共确定了 509 例 CTEPH 患者，其中 82%有 VTE 病史。在研究期间，CTEPH 的年发病率为 0.5 至 0.8 每 10 万人年。有 VTE 病史的患者 VTE 的发生率是无 VTE 病史患者的 2.5 倍（2571 比 980 每 10 万人年），而出血事件的发生率较低（5008 比 7139 每 10 万人年）。有 VTE 病史的 CTEPH 患者的 5 年生存率为 65%（95%CI，58%-71%），而无 VTE 病史的患者为 45%（95%CI，31%-58%）。
丹麦 CTEPH 的发病率与其他欧洲国家相当。我们发现了有和无 VTE 病史的 CTEPH 患者预后的显著差异。这些发现可能支持关于 CTEPH 病理生理学的假说的产生，并为当前的患者护理提供信息。
