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CTEPH risk factors

Multiple risk factors for CTEPH have been identified

Multiple factors related to pulmonary embolism (PE) can increase the risk of developing CTEPH1:

 

  • Recurrent, unprovoked, or idiopathic PE

  • Large perfusion defects when PE was detected

  • Younger or older age when PE was detected

  • Pulmonary-artery systolic pressure >50 mm Hg at first manifestation of PE

  • Persistent pulmonary hypertension (PH) evident when echocardiography is performed 6 months after acute PE was detected

 

*Based on a study with 223 patients in which 3.8% were diagnosed with CTEPH within 2 years of their first episode of pulmonary embolism with or without prior deep-vein thrombosis (95% CI, 1.1 to 6.5). CTEPH did not develop after two years in any of the 132 remaining patients with more than 2 years of follow-up.

 

 

As many as 1 out of 25 pulmonary embolism (PE) patients previously treated with ≥3 months of anticoagulation therapy could develop CTEPH2-4*

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*Based on a study with 223 patients in which 3.8% were diagnosed with CTEPH within 2 years of their first episode of pulmonary embolism with or without prior deep-vein thrombosis (95% CI, 1.1 to 6.5). CTEPH did not develop after two years in any of the 132 remaining patients with more than 2 years of follow-up.

 

Medical conditions associated with increased risk

In addition to these PE-related risk factors, some medical conditions independent of PE have been associated with increased risk of CTEPH5:

 

  • Infected surgical cardiac shunts or pacemaker or defibrillator leads

  • Splenectomy

  • Chronic inflammatory disorders

  • Antiphospholipid syndrome

  • Thyroid-replacement therapy

  • Cancer

 

Thrombotic and genetic factors that increase risk

Thrombotic and genetic factors may also increase risk of CTEPH5:

 

  • Lupus anticoagulant or antiphospholipid antibodies

  • Increased levels of factor VIII

  • Dysfibrinogenemia

  • ABO blood groups other than O

  • HLA polymorphisms

  • Abnormal endogenous fibrinolysis

  • Elevated plasma levels of lipoprotein(a)

 

The Risk Factors of CTEPH

Learn more about the 3 categories of risk factors for CTEPH.

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Learn about diagnosing CTEPH

References:

1. Kim NH and Lang IM. Risk factors for chronic thromboembolic pulmonary hypertension. Eur Respir Rev. 2012;21(123):27-31. 2. Tapson VF and Humbert M. Incidence and prevalence of chronic thromboembolic pulmonary hypertension: from acute to chronic pulmonary embolism. Proc Am Thorac Soc. 2006;3:564-567. 3. Pengo V, Lensing AWA, Prins MH, et al. Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med. 2004;350(22):2257-2264. 4. Wilkens H, Lang I, Behr J, et al. Chronic thromboembolic pulmonary hypertension (CTEPH): updated recommendations of the Cologne Consensus Conference 2011. Int J Cardiol. 2011;154(Suppl 1):S54-S60. 5. Piazza G and Goldhaber SZ. Chronic thromboembolic pulmonary hypertension. N Engl J Med. 2011;364:351-360.

 

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