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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\u003Cp id=\u0022p-1\u0022\u003EThe PADIS-PE study enrolled patients who had 1 prior episode of unprovoked pulmonary embolism. Analyses of baseline data found that independent risk factors for residual perfusion defect were older age, chronic respiratory disease, and right ventricular dysfunction at diagnosis. Low-molecular-weight heparin reduced the risk for residual perfusion defect.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Epulmonary embolism\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Erisk factors\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eresidual perfusion defects\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ewarfarin\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Elow molecular weight heparin\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ethrombotic disorders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecardiology \u0026amp; cardiovascular medicine clinical trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\u003Cp id=\u0022p-2\u0022\u003EPublished reports suggest that 30% to 50% of patients experiencing a pulmonary embolism (PE) have perfusion defects 6 to 12 months later [Cosmi B et al. \u003Cem\u003EIntern Emerg Med\u003C\/em\u003E. 2011; Sanchez O et al. \u003Cem\u003EJ Thromb Haemost\u003C\/em\u003E. 2010; Nijkeuter M et al. \u003Cem\u003EChest\u003C\/em\u003E. 2006]. An increased risk of dyspnea and greater pulmonary artery pressure can accompany these residual perfusion defects [Sanchez O et al. \u003Cem\u003EJ Thromb Haemost\u003C\/em\u003E. 2010]. The PADIS-PE study [\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00740883\u0026amp;atom=%2Fspmdc%2F15%2F21%2F10.atom\u0022\u003ENCT00740883\u003C\/a\u003E] was a randomized, double-blind, multicenter study conducted to determine the rate of residual perfusion defects and associated risk factors in patients who had experienced a single episode of unprovoked PE. The study results were presented by Olivier Sanchez, MD, PhD, Georges Pompidou European Hospital, Paris, France.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EThe study was conducted from 2007 to 2012 at multiple centers in France. Patients having their first unprovoked PE received 6 months of anticoagulation therapy, then underwent a lung ventilation\/perfusion (V\/Q) scan, echocardiography, and a leg ultrasound. Patients with a normal or near-normal V\/Q lung scan at baseline were classified as having no perfusion defect, and those with a pulmonary vascular obstruction \u2265\u200510% were classified as having a perfusion defect. Patients were randomized to 18 months of warfarin treatment (n\u2005=\u2005184) or placebo (n\u2005=\u2005187), evaluated at 18 months, and followed for another 24 months. Risk factors associated with the presence of residual perfusion defects were identified using univariate and multivariate analyses of the patients\u2019 baseline data.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EPE was initially diagnosed via positive spiral computed tomography in 285 patients (77%) and via high-probability V\/Q lung scan in 86 patients (23%). Proximal deep vein thrombosis and right ventricular dysfunction were diagnosed in 112 (30%) and 123 (33%) patients, respectively. A total of 234 patients received low-molecular-weight heparin (LMWH), 370 patients received vitamin K antagonists, 6 had fibrinolysis, and 1 patient was treated with rivaroxaban.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EIn this study, 124 patients (33%) had residual perfusion defects, 61 patients (16%) had residual deep vein thrombosis, and 95 (27%) had thrombophilia. The mean\u2005\u00b1\u2005SD D-dimer level was 352\u2005\u00b1\u2005459 \u00b5g\/L. Univariate analysis indicated that patients with a perfusion defect were significantly older (66 vs 53 years; OR, 1.05; 95% CI, 1.03 to 1.06; \u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.0001), and that significantly higher proportions of patients with a perfusion defect had chronic respiratory disease (39 vs 34%; OR, 2.77; 95% CI, 1.64 to 4.67; \u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.001) and chronic cardiac disease (9 vs 4%; OR, 4.60; 95% CI, 1.39 to 15.2; \u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.013). Independent risk factors for residual perfusion defects identified in the multivariate analysis included age \u0026gt;\u200565 years (OR, 3.28; 95% CI, 1.91 to 5.63; \u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.0001), chronic respiratory disease (OR, 2.10; 95% CI, 1.12 to 3.93; \u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.021), and right ventricular dysfunction at diagnosis (OR 1.96; 95% CI, 1.14 to 3.37; \u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.014). Initial treatment with LMWH vs unfractionated heparin or pentasaccharide was associated with a decreased risk of residual perfusion defects (OR, 0.50; 95% CI, 0.29 to 0.86; \u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.013).\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/21\/10.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzlgde\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}