Longitudinal Study to Identify Predictive Factors of Post-thrombotic Pulmonary Hypertension

March 19, 2021 updated by: Ferran Barbe, Sociedad Española de Neumología y Cirugía Torácica

The current data on the incidence of pulmonary hypertension (PH) are very variable, depending on the different studies designs. There are no data on the prognostic of PH in patients with asymptomatic pulmonary thromboembolisms (PT), neither paucisymptomatic PH, in which without a prospective follow-up would be underdiagnosed. We thought that the prognosis of both clinical forms (PT with or without symptoms) would be similar.

The objective of this study is know the real incidence of pulmonary hypertension (PH) post symptomatic and asymptomatic pulmonary thromboembolic (PT).

Study Overview

Status

Completed

Conditions

Detailed Description

Rationale

Pulmonary hypertension (PH) post pulmonary thromboembolisms is a serious and complex disease, is one major cause of pulmonary hypertension (1). It is the most feared late complication of pulmonary thromboembolism (PT) characterized by the organization of thrombotic material within the pulmonary arteries (2). Although a purely mechanical theory is too simplistic in view of the lack of correlation between the proportion of obliterated pulmonary arteries and the numbers of PH.

Acute, symptomatic, or asymptomatic PT may be the initial event, but disease progression would result from progressive vascular remodeling of small vessels. It is possible that unresolved pulmonary arterial thrombosis is a decisive factor for vascular endothelial cells to initiate their mesenchymal transition (3).

On the other hand, Pulmonary hypertension post pulmonary thromboembolisms is the only subclass of pulmonary hypertension that has a curative surgical treatment (4). The diagnosis of this situation should be detected as soon as possible to optimize the results of surgical and pharmacological treatment. Surgical indication should be established as early as possible to avoid progression (5).

Hypothesis

The current data on the incidence of PH are very variable, depending on the different studies designs. There are no data on the prognostic of PH in patients with asymptomatic PT, neither paucisymptomatic PH, in which without a prospective follow-up would be underdiagnosed. We thought that the prognosis of both clinical forms (PT with or without symptoms) would be similar. Also we thought and that there are forms of paucisymptomatic PH whose diagnosis and treatment would benefit from a prospective follow-up.

Objectives

Main objective

To know the incidence of pulmonary hypertension (PH) post symptomatic and asymptomatic pulmonary thromboembolic (PT).

The secondary objectives of the study are:

  • To defined clinical subtypes of PT with a predictive value of diagnosis of PH in two years.
  • To Measure biomarkers described that may be related to the diagnosis of PH or the disease progression.
  • Use of genetic, proteomic, RNA transcription, cytometric and cellular and metabolic identification assays to aid in the search for new genetic factors and / or PH biomarkers.

Study Type

Observational

Enrollment (Actual)

1025

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Alava, Spain
        • Hospital de Araba
      • Barcelona, Spain
        • Hospital del Mar
      • Gerona, Spain
        • Hospital U. de Girona Doctor Josep Trueta
      • Granada, Spain
        • Hospital U. Virgen de las Nieves
      • Madrid, Spain
        • Hospital U. La Paz
      • Madrid, Spain
        • Hospital U. Ramon y Cajal
      • Sevilla, Spain
        • Hospital San Juan de Dios
      • Valladolid, Spain
        • Hospital C. U. de Valladolid
      • Zaragoza, Spain
        • Hospital C. U. Lozano Blesa
    • Asturias
      • Oviedo, Asturias, Spain
        • Hospital U. Central. de Asturias
    • Barcelona
      • Badalona, Barcelona, Spain
        • Hospital M. de Badalona
      • Badalona, Barcelona, Spain
        • Hospital U. German Trias i Pujol
      • Sant Cugat del Valles, Barcelona, Spain
        • Hospital G. de Cataluña
      • Viladecans, Barcelona, Spain
        • Hospital de Viladecans
    • Cantabria
      • Santander, Cantabria, Spain
        • Hospital U. Marques de Valdecilla
      • Torrelavega, Cantabria, Spain
        • Hospital Sierrallana
    • Guipuzcua
      • Bilbao, Guipuzcua, Spain
        • Hospital de Cruces
    • La Rioja
      • Logrono, La Rioja, Spain
        • Hospital San Pedro
    • Madrid
      • Alcorcón, Madrid, Spain
        • Hospital U. Fundación Alcorcón
      • Getafe, Madrid, Spain
        • Hospital U. de Getafe
    • Navarra
      • Pamplona, Navarra, Spain
        • Hospital Virgen del Camino
    • Sevilla
      • Seville, Sevilla, Spain, 41013
        • Hospital Virgen del Rocío
    • Vizcaya
      • Galdacano, Vizcaya, Spain
        • Hospital Galdakao-Usansolo

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Probability Sample

Study Population

Patient with diagnosis of incidental or symptomatic pulmonary thromboembolisms

Description

Inclusion Criteria:

  • Patients 18 years or older and able to provide informed consent
  • Diagnosis of pulmonary thromboembolisms confirmed by
  • Computed Tomography Angiography (CTA) if there are a partial transluminal defect surrounded by contrast or a complete occlusion of pulmonary artery.
  • Pulmonary ventilation/perfusion scan.- Patients with high risk based on PIOPED study criteria or in patients with deep venous thrombosis confirmed by echography and positron emission tomography (PET) scan not concluding.

Exclusion Criteria:

  • Any contraindication to the performance of the pulmonary hypertension diagnostic tests
  • Any circumstance, to investigator criteria, to impede the patient follow up
  • Life expectancy lower than 6 months

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pulmonary hypertension
Time Frame: 2 years
Diagnosis on pulmonary hypertension after pulmonary thromboembolism
2 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Study Chair: Remedios Otero Candelera, Hospital Universitario Virgen del Rocío IBIS

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 24, 2013

Primary Completion (Actual)

June 30, 2019

Study Completion (Actual)

July 30, 2019

Study Registration Dates

First Submitted

April 26, 2017

First Submitted That Met QC Criteria

April 26, 2017

First Posted (Actual)

May 1, 2017

Study Record Updates

Last Update Posted (Actual)

March 22, 2021

Last Update Submitted That Met QC Criteria

March 19, 2021

Last Verified

March 1, 2021

More Information

Terms related to this study

Other Study ID Numbers

  • OSIRIS

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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