Cardiovascular DiseasesSCOPENCT01781858
Study on the Clinical Course Of Pulmonary Embolism
An observational study of Cardiovascular Diseases and Venous Thromboembolism, run by University of Padova.
Trial summary
The course of both pulmonary embolism (PE) and one of its more relevant late complications, i.e. chronic thromboembolic pulmonary hypertension (CTEPH) is still substantially unknown. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Cardiovascular Diseases, Venous Thromboembolism, Pulmonary Hypertension
- How many people
- 700 participants
- Where
- No sites listed yet
- Study dates
- Jan 2008to Jul 2014
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Consecutive outpatients or inpatients with an objective diagnosis of first acute PE episode.
Who may be able to join
- Consecutive Outpatients/Inpatients with acute first episode of acute pulmonary embolism
Who cannot join
- Pregnancy
- Age < 18 years
- expected survival < 2 years
- previous episodes of VTE
- need for anticoagulation for reasons other than VTE
- preexisting severe cardiac or pulmonary diseases
Show all 10Show fewer
- preexisting diseases that could cause non thromboembolic pulmonary hypertension
- Patients geographically inaccessible for follow up
- Low compliance to anticoagulant therapy and planned diagnostic work-up
- Refusal to give written informed consent
About this study
The course of both pulmonary embolism (PE) and one of its more relevant late complications, i.e. chronic thromboembolic pulmonary hypertension (CTEPH) is still substantially unknown.
Recent evidence has shown that the incidence of CTEPH is higher than previously believed, but this has not been confirmed by other studies. A clear link between PE and CTEPH has been questioned by some experts. A great number of patients affected by PE persistently have residual chronic thromboembolic material the meaning of which is a matter of debate. The evidence sustaining a link between chronic residual PE and subsequent PE recurrences or CTEPH is insufficient.
Read more
Thus, a nationwide, multicentre, prospective cohort study was designed with the following aims:
- to ascertain the incidence of symptomatic CTEPH after a first episode of acute PE;
- to ascertain the incidence of venous thromboembolic (VTE) recurrences after a first episode of acute PE;
- to evaluate whether a relation exists between chronic residual PE and CTEPH
- to evaluate whether a relation exists between chronic residual PE and VTE recurrences;
- to evaluate whether a relation exists between persistent right ventricular dysfunction and CTEPH;
- to evaluate whether a relation exists between persistent right ventricular dysfunction and PE recurrences.
For each enrolling centre, consecutive outpatients or inpatients with an objectively diagnosed first acute PE episode are considered eligible.
Read the detailed description
All patients enrolled in the study received a diagnosis of PE by means of chest CT scan, lung scanning or pulmonary angiography. All patients should undergo an echocardiographic examination during the acute phase of PE, when this is possible. All patients will be treated according to current international guidelines and local protocols. All surviving patients will receive an echocardiographic examination after 6 weeks and 6 months. All surviving patients will receive a perfusional pulmonary scintigraphy at 6 months and be subsequently followed up every 6 months for at least 3 years.
In case of clinical suspicion of VTE recurrence a diagnostic procedure will be performed in order to confirm the recurrent VTE episode ( Chest CT scan, lung scan, Pulmonary angiography, compressive ultrasound, phlebography, vein CT scan).
In case of clinical suspicion of CTEPH, a further diagnostic workup will be performed, consisting in echocardiography, ventilation/perfusion lung scanning, multidetector chest CT scanning, and pulmonary angiography, with direct measurement of the pulmonary-artery pressure.
The extension of pulmonary embolism during the acute phase will be graded according to a standardized scoring system by local investigators while the extension of chronic residual pulmonary embolism will be graded according to a standardized scoring system ( Meyer score) by both local investigators and an independent committee. All outcome events will be centrally adjudicated by an independent committee.
All clinical data ( initial data on medical history, clinical symptoms, presence of risk factors, diagnoses, diagnostic tests results, treatment type and duration, outcome events and other) will be collected by the local investigators in an electronic medical database. Related data will be sent to the coordinating centre on a regular basis. All recruiting centres will be regularly monitored by the coordinating Centre.
- Keywords
- Pulmonary embolism, Chronic thromboembolic pulmonary hypertension, Venous thromboembolism
- Medical subject headings
- Cardiovascular Diseases, Venous Thromboembolism, Hypertension, Pulmonary, Pulmonary Embolism
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| pulmonary embolism | Consecutive outpatients and inpatients with first episode of acute pulmonary embolism |
What is being measured
The primary outcome is the main question the study is designed to answer.
Incidence of chronic thromboembolic pulmonary hypertension
Measured: within 3 years
Secondary outcomes (1)
Incidence of recurrent venous thromboembolic events
Measured: within 3 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted1 Feb 2013 (estimated)
- Study startJan 2008
- Primary completionMay 2014
- Study completionJul 2014
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (22)Papers the sponsor has linked to this study.
- Other trials for Cardiovascular DiseasesStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 700 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Padova
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Raffaele Pesavento, University of Padova
- Investigators
- Raffaele Pesavento, MD, Study director, University of PadovaPaolo Prandoni, MD,PHD, Study chair, University of PadovaAntonio Pagnan, MD, Study chair, University of PadovaGualtiero Palareti, MD, Study chair, University of BolognaAntonio Palla, MD, Study chair, University of PisaVittorio Pengo, MD, Study chair, University of PadovaFranco Piovella, MD, Study chair, University of Pavia - Italy
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01781858
- Sponsor's protocol ID
- Scope-001
- Acronym
- SCOPE
- Status last verified
- Jun 2016
- First submitted
- 30 Jan 2013
- Last updated
- 14 Jun 2016
- Results posted
- No
- Data monitoring committee
- No
Publications
Pengo V, Lensing AW, Prins MH, Marchiori A, Davidson BL, Tiozzo F, Albanese P, Biasiolo A, Pegoraro C, Iliceto S, Prandoni P; Thromboembolic Pulmonary Hypertension Study Group. Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med. 2004 May 27;350(22):2257-64. doi: 10.1056/NEJMoa032274.
PubMed 15163775Becattini C, Agnelli G, Pesavento R, Silingardi M, Poggio R, Taliani MR, Ageno W. Incidence of chronic thromboembolic pulmonary hypertension after a first episode of pulmonary embolism. Chest. 2006 Jul;130(1):172-5. doi: 10.1378/chest.130.1.172.
PubMed 16840398Lang IM, Pesavento R, Bonderman D, Yuan JX. Risk factors and basic mechanisms of chronic thromboembolic pulmonary hypertension: a current understanding. Eur Respir J. 2013 Feb;41(2):462-8. doi: 10.1183/09031936.00049312. Epub 2012 Jun 14.
PubMed 22700839Prandoni P, Noventa F, Ghirarduzzi A, Pengo V, Bernardi E, Pesavento R, Iotti M, Tormene D, Simioni P, Pagnan A. The risk of recurrent venous thromboembolism after discontinuing anticoagulation in patients with acute proximal deep vein thrombosis or pulmonary embolism. A prospective cohort study in 1,626 patients. Haematologica. 2007 Feb;92(2):199-205. doi: 10.3324/haematol.10516.
PubMed 17296569Verso M, Agnelli G, Ageno W, Imberti D, Moia M, Palareti G, Pistelli R, Cantone V; MASTER investigators. Long-term death and recurrence in patients with acute venous thromboembolism: the MASTER registry. Thromb Res. 2012 Sep;130(3):369-73. doi: 10.1016/j.thromres.2012.04.003. Epub 2012 May 13.
PubMed 22583838Cosmi B, Nijkeuter M, Valentino M, Huisman MV, Barozzi L, Palareti G. Residual emboli on lung perfusion scan or multidetector computed tomography after a first episode of acute pulmonary embolism. Intern Emerg Med. 2011 Dec;6(6):521-8. doi: 10.1007/s11739-011-0577-8. Epub 2011 Apr 3.
PubMed 21461909Alhadad A, Miniati M, Alhadad H, Gottsater A, Bajc M. The value of tomographic ventilation/perfusion scintigraphy (V/PSPECT) for follow-up and prediction of recurrence in pulmonary embolism. Thromb Res. 2012 Dec;130(6):877-81. doi: 10.1016/j.thromres.2012.09.002. Epub 2012 Sep 29.
PubMed 23026380Poli D, Miniati M. The incidence of recurrent venous thromboembolism and chronic thromboembolic pulmonary hypertension following a first episode of pulmonary embolism. Curr Opin Pulm Med. 2011 Sep;17(5):392-7. doi: 10.1097/MCP.0b013e328349289a.
PubMed 21743331Poli D, Grifoni E, Antonucci E, Arcangeli C, Prisco D, Abbate R, Miniati M. Incidence of recurrent venous thromboembolism and of chronic thromboembolic pulmonary hypertension in patients after a first episode of pulmonary embolism. J Thromb Thrombolysis. 2010 Oct;30(3):294-9. doi: 10.1007/s11239-010-0452-x.
PubMed 20157841Miniati M, Monti S, Bottai M, Scoscia E, Bauleo C, Tonelli L, Dainelli A, Giuntini C. Survival and restoration of pulmonary perfusion in a long-term follow-up of patients after acute pulmonary embolism. Medicine (Baltimore). 2006 Sep;85(5):253-262. doi: 10.1097/01.md.0000236952.87590.c8.
PubMed 16974210Nijkeuter M, Sohne M, Tick LW, Kamphuisen PW, Kramer MH, Laterveer L, van Houten AA, Kruip MJ, Leebeek FW, Buller HR, Huisman MV; Christopher Study Investigators. The natural course of hemodynamically stable pulmonary embolism: Clinical outcome and risk factors in a large prospective cohort study. Chest. 2007 Feb;131(2):517-23. doi: 10.1378/chest.05-2799.
PubMed 17296656Nijkeuter M, Hovens MM, Davidson BL, Huisman MV. Resolution of thromboemboli in patients with acute pulmonary embolism: a systematic review. Chest. 2006 Jan;129(1):192-7. doi: 10.1378/chest.129.1.192.
PubMed 16424432Pepke-Zaba J, Delcroix M, Lang I, Mayer E, Jansa P, Ambroz D, Treacy C, D'Armini AM, Morsolini M, Snijder R, Bresser P, Torbicki A, Kristensen B, Lewczuk J, Simkova I, Barbera JA, de Perrot M, Hoeper MM, Gaine S, Speich R, Gomez-Sanchez MA, Kovacs G, Hamid AM, Jais X, Simonneau G. Chronic thromboembolic pulmonary hypertension (CTEPH): results from an international prospective registry. Circulation. 2011 Nov 1;124(18):1973-81. doi: 10.1161/CIRCULATIONAHA.110.015008. Epub 2011 Oct 3.
PubMed 21969018Korkmaz A, Ozlu T, Ozsu S, Kazaz Z, Bulbul Y. Long-term outcomes in acute pulmonary thromboembolism: the incidence of chronic thromboembolic pulmonary hypertension and associated risk factors. Clin Appl Thromb Hemost. 2012 Jun;18(3):281-8. doi: 10.1177/1076029611431956. Epub 2012 Jan 23.
PubMed 22275389Wilkens H, Lang I, Behr J, Berghaus T, Grohe C, Guth S, Hoeper MM, Kramm T, Kruger U, Langer F, Rosenkranz S, Schafers HJ, Schmidt M, Seyfarth HJ, Wahlers T, Worth H, Mayer E. Chronic thromboembolic pulmonary hypertension (CTEPH): updated Recommendations of the Cologne Consensus Conference 2011. Int J Cardiol. 2011 Dec;154 Suppl 1:S54-60. doi: 10.1016/S0167-5273(11)70493-4.
PubMed 22221974
Study at a glance
From the registry record, last updated by the sponsor on 14 Jun 2016. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Study on the Clinical Course Of Pulmonary Embolism
- ClinicalTrials.gov ID
- NCT01781858
- Acronym / sponsor ID
- SCOPE / Scope-001
- Keywords
- Pulmonary embolism, Chronic thromboembolic pulmonary hypertension, Venous thromboembolism
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 700 participants (actual)
- Lead sponsor
- University of PadovaUniversity, hospital or other
- Study start
- Jan 2008
- Primary completion
- May 2014 (actual)
- Study completion
- Jul 2014 (actual)
- First posted
- 1 Feb 2013 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The course of both pulmonary embolism (PE) and one of its more relevant late complications, i.e. chronic thromboembolic pulmonary hypertension (CTEPH) is still substantially unknown.
Recent evidence has shown that the incidence of CTEPH is higher than previously believed, but this has not been confirmed by other studies. A clear link between PE and CTEPH has been questioned by some experts. A great number of patients affected by PE persistently have residual chronic thromboembolic material the meaning of which is a matter of debate. The evidence sustaining a link between chronic residual PE and subsequent PE recurrences or CTEPH is insufficient.
Thus, a nationwide, multicentre, prospective cohort study was designed with the following aims:
- to ascertain the incidence of symptomatic CTEPH after a first episode of acute PE;
- to ascertain the incidence of venous thromboembolic (VTE) recurrences after a first episode of acute PE;
- to evaluate whether a relation exists between chronic residual PE and CTEPH
- to evaluate whether a relation exists between chronic residual PE and VTE recurrences;
- to evaluate whether a relation exists between persistent right ventricular dysfunction and CTEPH;
- to evaluate whether a relation exists between persistent right ventricular dysfunction and PE recurrences.
For each enrolling centre, consecutive outpatients or inpatients with an objectively diagnosed first acute PE episode are considered eligible.
Detailed description
All patients enrolled in the study received a diagnosis of PE by means of chest CT scan, lung scanning or pulmonary angiography. All patients should undergo an echocardiographic examination during the acute phase of PE, when this is possible. All patients will be treated according to current international guidelines and local protocols. All surviving patients will receive an echocardiographic examination after 6 weeks and 6 months. All surviving patients will receive a perfusional pulmonary scintigraphy at 6 months and be subsequently followed up every 6 months for at least 3 years.
In case of clinical suspicion of VTE recurrence a diagnostic procedure will be performed in order to confirm the recurrent VTE episode ( Chest CT scan, lung scan, Pulmonary angiography, compressive ultrasound, phlebography, vein CT scan).
In case of clinical suspicion of CTEPH, a further diagnostic workup will be performed, consisting in echocardiography, ventilation/perfusion lung scanning, multidetector chest CT scanning, and pulmonary angiography, with direct measurement of the pulmonary-artery pressure.
The extension of pulmonary embolism during the acute phase will be graded according to a standardized scoring system by local investigators while the extension of chronic residual pulmonary embolism will be graded according to a standardized scoring system ( Meyer score) by both local investigators and an independent committee. All outcome events will be centrally adjudicated by an independent committee.
All clinical data ( initial data on medical history, clinical symptoms, presence of risk factors, diagnoses, diagnostic tests results, treatment type and duration, outcome events and other) will be collected by the local investigators in an electronic medical database. Related data will be sent to the coordinating centre on a regular basis. All recruiting centres will be regularly monitored by the coordinating Centre.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| pulmonary embolism | – | –Consecutive outpatients and inpatients with first episode of acute pulmonary embolism |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Consecutive outpatients or inpatients with an objective diagnosis of first acute PE episode.
Key inclusion criteria (1 listed)
- Consecutive Outpatients/Inpatients with acute first episode of acute pulmonary embolism
Key exclusion criteria (10 listed)
- Pregnancy
- Age < 18 years
- expected survival < 2 years
- previous episodes of VTE
- need for anticoagulation for reasons other than VTE
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Incidence of chronic thromboembolic pulmonary hypertension
Time frame: within 3 years
1 secondary outcome
Incidence of recurrent venous thromboembolic events
Time frame: within 3 years
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 Jun 2016.
- Background: PubMed 15163775Pengo V, Lensing AW, Prins MH, Marchiori A, Davidson BL, Tiozzo F, Albanese P, Biasiolo A, Pegoraro C, Iliceto S, Prandoni P; Thromboembolic Pulmonary Hypertension Study Group. Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med. 2004 May 27;350(22):2257-64. doi: 10.1056/NEJMoa032274.
- Background: PubMed 16840398Becattini C, Agnelli G, Pesavento R, Silingardi M, Poggio R, Taliani MR, Ageno W. Incidence of chronic thromboembolic pulmonary hypertension after a first episode of pulmonary embolism. Chest. 2006 Jul;130(1):172-5. doi: 10.1378/chest.130.1.172.
- Background: PubMed 22700839Lang IM, Pesavento R, Bonderman D, Yuan JX. Risk factors and basic mechanisms of chronic thromboembolic pulmonary hypertension: a current understanding. Eur Respir J. 2013 Feb;41(2):462-8. doi: 10.1183/09031936.00049312. Epub 2012 Jun 14.
- Background: PubMed 17296569Prandoni P, Noventa F, Ghirarduzzi A, Pengo V, Bernardi E, Pesavento R, Iotti M, Tormene D, Simioni P, Pagnan A. The risk of recurrent venous thromboembolism after discontinuing anticoagulation in patients with acute proximal deep vein thrombosis or pulmonary embolism. A prospective cohort study in 1,626 patients. Haematologica. 2007 Feb;92(2):199-205. doi: 10.3324/haematol.10516.
- Background: PubMed 22583838Verso M, Agnelli G, Ageno W, Imberti D, Moia M, Palareti G, Pistelli R, Cantone V; MASTER investigators. Long-term death and recurrence in patients with acute venous thromboembolism: the MASTER registry. Thromb Res. 2012 Sep;130(3):369-73. doi: 10.1016/j.thromres.2012.04.003. Epub 2012 May 13.
- Background: PubMed 21461909Cosmi B, Nijkeuter M, Valentino M, Huisman MV, Barozzi L, Palareti G. Residual emboli on lung perfusion scan or multidetector computed tomography after a first episode of acute pulmonary embolism. Intern Emerg Med. 2011 Dec;6(6):521-8. doi: 10.1007/s11739-011-0577-8. Epub 2011 Apr 3.
- Background: PubMed 23026380Alhadad A, Miniati M, Alhadad H, Gottsater A, Bajc M. The value of tomographic ventilation/perfusion scintigraphy (V/PSPECT) for follow-up and prediction of recurrence in pulmonary embolism. Thromb Res. 2012 Dec;130(6):877-81. doi: 10.1016/j.thromres.2012.09.002. Epub 2012 Sep 29.
- Background: PubMed 21743331Poli D, Miniati M. The incidence of recurrent venous thromboembolism and chronic thromboembolic pulmonary hypertension following a first episode of pulmonary embolism. Curr Opin Pulm Med. 2011 Sep;17(5):392-7. doi: 10.1097/MCP.0b013e328349289a.
- Background: PubMed 20157841Poli D, Grifoni E, Antonucci E, Arcangeli C, Prisco D, Abbate R, Miniati M. Incidence of recurrent venous thromboembolism and of chronic thromboembolic pulmonary hypertension in patients after a first episode of pulmonary embolism. J Thromb Thrombolysis. 2010 Oct;30(3):294-9. doi: 10.1007/s11239-010-0452-x.
- Background: PubMed 16974210Miniati M, Monti S, Bottai M, Scoscia E, Bauleo C, Tonelli L, Dainelli A, Giuntini C. Survival and restoration of pulmonary perfusion in a long-term follow-up of patients after acute pulmonary embolism. Medicine (Baltimore). 2006 Sep;85(5):253-262. doi: 10.1097/01.md.0000236952.87590.c8.
- Background: PubMed 17296656Nijkeuter M, Sohne M, Tick LW, Kamphuisen PW, Kramer MH, Laterveer L, van Houten AA, Kruip MJ, Leebeek FW, Buller HR, Huisman MV; Christopher Study Investigators. The natural course of hemodynamically stable pulmonary embolism: Clinical outcome and risk factors in a large prospective cohort study. Chest. 2007 Feb;131(2):517-23. doi: 10.1378/chest.05-2799.
- Background: PubMed 16424432Nijkeuter M, Hovens MM, Davidson BL, Huisman MV. Resolution of thromboemboli in patients with acute pulmonary embolism: a systematic review. Chest. 2006 Jan;129(1):192-7. doi: 10.1378/chest.129.1.192.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Raffaele Pesavento, MD study director
University of Padova
Paolo Prandoni, MD,PHD study chair
University of Padova
Antonio Pagnan, MD study chair
University of Padova
Questions about this trial
What is this clinical trial studying?
An observational study of Cardiovascular Diseases and Venous Thromboembolism, run by University of Padova.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 14 Jun 2016. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Incidence of chronic thromboembolic pulmonary hypertension (time frame: within 3 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01781858, which also lists 22 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Jun 2016.