Contemporary clinical management of acute pulmonary embolism: the COPE study

Cecilia Becattini, Giancarlo Agnelli, Aldo Pietro Maggioni, Francesco Dentali, Andrea Fabbri, Iolanda Enea, Fulvio Pomero, Maria Pia Ruggieri, Andrea Di Lenarda, Michele Gulizia, Cecilia Becattini, Giancarlo Agnelli, Aldo Pietro Maggioni, Francesco Dentali, Andrea Fabbri, Iolanda Enea, Fulvio Pomero, Maria Pia Ruggieri, Andrea Di Lenarda, Michele Gulizia

Abstract

Background: New management, risk stratification and treatment strategies have become available over the last years for patients with acute pulmonary embolism (PE), potentially leading to changes in clinical practice and improvement of patients' outcome.

Methods: The COntemporary management of Pulmonary Embolism (COPE) is a prospective, non-interventional, multicentre study in patients with acute PE evaluated at internal medicine, cardiology and emergency departments in Italy. The aim of the COPE study is to assess contemporary management strategies in patients with acute, symptomatic, objectively confirmed PE concerning diagnosis, risk stratification, hospitalization and treatment and to assess rates and predictors of in-hospital and 30-day mortality. The composite of death (either overall or PE-related) or clinical deterioration at 30 days from the diagnosis of PE, major bleeding occurring in hospital and up to 30 days from the diagnosis of PE and adherence to guidelines of the European Society of Cardiology (ESC) are secondary study outcomes. Participation in controlled trials on the management of acute PE is the only exclusion criteria. Expecting a 10-15%, 3% and 0.5% incidence of death for patients with high, intermediate or low-risk PE, respectively, it is estimated that 400 patients with high, 2100 patients with intermediate and 2500 with low-risk PE should be included in the study. This will allow to have about 100 deaths in study patients and will empower assessment of independent predictors of death.

Conclusions: COPE will provide contemporary data on in-hospital and 30-day mortality of patients with documented PE as well as information on guidelines adherence and its impact on clinical outcomes.

Trail registration: NCT number: NCT03631810.

Keywords: Anticoagulants; Outcome; Pulmonary embolism; Registry.

Conflict of interest statement

C.B. reports personal fees from Bayer HealthCare, Bristol Myers Squibb and Daiichi Sankyo all outside the submitted study. G.A. reports personal fees from Pfizer, personal fees from Bayer Healthcare, from Daichi Sankyo, outside the submitted work. A.P.M. reports honoraria for participation in committees of studies sponsored by Bayer, Novartis and Fresenius. M.M.G., A.L., F.D., I.E., F.P., A.F., M.P.R. have nothing to disclose.

© 2022. The Author(s).

Figures

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Fig. 1
Study design

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