AUTHOR=Pang Wenyi , Zhang Zhu , Wang Zenghui , Zhen Kaiyuan , Zhang Meng , Zhang Yunxia , Gao Qian , Zhang Shuai , Tao Xincao , Wan Jun , Xie Wanmu , Zhai Zhenguo 

TITLE=Higher Incidence of Chronic Thromboembolic Pulmonary Hypertension After Acute Pulmonary Embolism in Asians Than in Europeans: A Meta-Analysis

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.721294

DOI=10.3389/fmed.2021.721294

ISSN=2296-858X

ABSTRACT=<p><bold>Aim:</bold> To summarize the incidence of right heart catheter diagnosed chronic thromboembolic pulmonary hypertension (CTEPH) after acute pulmonary embolism (PE) in a meta-analysis.</p><p><bold>Methods:</bold> Cohort studies reporting the incidence of CTEPH after acute PE were identified <italic>via</italic> search of Medline, Embase, China National Knowledge Infrastructure and WanFang databases.</p><p><bold>Results:</bold> Twenty-two cohort studies with 5,834 acute PE patients were included. Pooled results showed that the overall incidence of CTEPH was 2.82% (95% CI: 2.11–3.53%). Subgroup analyses showed higher incidence of CTEPH in Asians than Europeans (5.08 vs. 1.96%, <italic>p</italic> = 0.01), in retrospective cohorts than prospective cohorts (4.75 vs. 2.47%, <italic>p</italic> = 0.02), and in studies with smaller sample size than those with larger sample size (4.57 vs. 1.71%, <italic>p</italic> &lt; 0.001). Stratified analyses showed previous venous thromboembolic events and unprovoked PE were both significantly associated with increased risk of CTEPH (OR = 2.57 and 2.71, respectively; both <italic>p</italic> &lt; 0.01).</p><p><bold>Conclusions:</bold> The incidence of CTEPH after acute PE is ~3% and the incidence is higher in Asians than Europeans. Efforts should be made for the early diagnosis and treatment of CTEPH in PE patients, particularly for high-risk population.</p>