TY - JOUR T1 - Chronic thromboembolic pulmonary hypertension after acute pulmonary embolism: to screen or not to screen? JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00440-2018 VL - 51 IS - 4 SP - 1800440 AU - Marius M. Hoeper Y1 - 2018/04/01 UR - http://erj.ersjournals.com/content/51/4/1800440.abstract N2 - How many patients who survive acute pulmonary embolism will eventually develop chronic thromboembolic pulmonary hypertension (CTEPH) and is the risk sufficiently high to call for systematic screening? These two questions are obviously connected and the ongoing debate reflects a lack of robust data. Previous estimates on the incidence of CTEPH after acute pulmonary embolism have ranged from 0.1% [1] to 9.1% [2]; an almost 2-log difference. A widely regarded Italian study of 223 consecutive patients with acute pulmonary embolism found a cumulative CTEPH incidence of 3.8% after 2 years; no additional CTEPH cases were identified during long-term follow-up [3]. In contrast, a more recent series, also from Italy, that included 647 patients with acute embolism found a cumulative CTEPH incidence of 1.7% during a 3-year follow-up [4, 5]. A recent meta-analysis of 41 studies narrowed the numbers down but still provided conflicting results [6]: 0.56% of all patients with acute pulmonary embolism developed CTEPH over a period of 2–3 years; however, in a subset of four studies that included only survivors of acute pulmonary embolism, the CTEPH incidence was 3.2%.As the risk of CTEPH in survivors of acute pulmonary embolism is probably in the range of 0.5–1.0%, screening is unlikely to be efficacious http://ow.ly/66ov30iWjnY ER -