* The COMMAND VTE Registry-2 study tracked 5,197 patients with venous thromboembolism in Japan, finding that 2.3% of those with acute PE developed CTEPH over an average follow-up of 747 days.
* Identified risk factors for developing CTEPH included being female, longer time from symptom onset to PE diagnosis, experiencing hypoxemia, having right heart load, lower D-dimer levels, and having
The simplified Pulmonary Embolism Severity Index (sPESI) score helps identify low-risk patients for home treatment of pulmonary embolism, but its use with direct oral anticoagulants hasn't been thoroughly studied.
A study of 2,496 patients with stable pulmonary embolism found that only 25% had an sPESI score of 0, and among those, only 17% were treated at home, though their 30-day mortality was notably low (0% vs. 4.8% in higher risk groups).
Factors promoting home treatment included the absence of temporary risk factors, no elevated cardiac biomarkers, and the use of direct oral anticoagulants during the acute phase.
A study in Japan compared outcomes of patients with venous thromboembolism (VTE) treated with warfarin (2010-2014) versus direct oral anticoagulants (DOACs) (2015-2020) from two multicenter registries.
The use of DOACs skyrocketed from 2.6% in the warfarin era to 79% in the DOAC era, leading to a significant reduction in the 5-year recurrence rate of VTE (10.5% to 9.5%).
However, the incidence of major bleeding remained similar between the two eras, indicating that while DOACs may reduce VTE recurrence, concerns about bleeding risks continue.