Source: Annual Congress 2006 - Pulmonary hypertension: thromo-embolic processes
Disease area: Pulmonary vascular diseases

Abstract

Introduction: Based on SEPAR guidelines and the 7^th ACCP Consensus Conference indefinite treatment for pulmonary embolism(PE) is recommended when active cancer and some thrombophilias are present, and is suggested in second episode, idiopathic PE and in most trombophilias. In addition, it is advised to appraise the presence of residual venous thrombosis (RVT). Aim: To know how many of our patients with PE are candidates for indefinite treatment. Methods: follow up 45 months. Patients: consecutive PE (diagnosed by CTangiography), both outpatients and hospitalized in Cruces Hospital, and followed up for at least 3 months. Average follow up: 15 months. Anticoagulant therapy algorithm: indefinite in patients with cancer and second episode and probably indefinite in idiopathic cases, taking in account presence of thrombophilia and/or RVT. Results: Total patients 388. Average age: 68(21-96). Deaths before 3^rd month 60(15%), lost 8(2%). Followed up: 320. Active cancer presence 68/320(21%). PE was a second or next episode in 25/320 (8%), idiopathic 119/320(37%). 14/320(5%) kept their risk factor (immobilization) and 94/320(29%) had a transitory risk factor. However afterwards risk factors were detected in 13 patients of this group (1 thrombophilia and RVT, 8 thrombophilias and 4 RVT). No risk factors for recurrence were found in 81/320(25%)
Conclusions:1.In our area nearly in 20% of patients with PE indefinite anticoagulant therapy is recommended. 2.According to several risk factors indefinite treatment is suggested in approximately the 50%. 3.Only in 25% it is clearly recommended to interrupt the treatment in 3-6 months. 4.Impact of these results in the planning of resources is still to be studied.

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B. Gomez, F. Uresandi, G. Iruin, L. Garcia-Echeberria, P. Sobradillo, P. Losada, A. Gomez, M. Iriberri (Barakaldo, Spain). Recommended uses for indefinite secondary prophylaxis in patients with pulmonary embolism. Eur Respir J 2006; 28: Suppl. 50, 2370

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