Pierre–Yves Le Roux , Philippe Robin , Romain Le Pennec , Cécile Tromeur , Francis Couturaud , Julien Asselineau , Grégoire Le Gal , Pierre–Yves Salaun
{"title":"使用通气/灌注单光子发射计算机断层扫描/计算机断层扫描预测肺栓塞患者静脉血栓栓塞复发风险:队列研究方案(PRONOSPECT)","authors":"Pierre–Yves Le Roux , Philippe Robin , Romain Le Pennec , Cécile Tromeur , Francis Couturaud , Julien Asselineau , Grégoire Le Gal , Pierre–Yves Salaun","doi":"10.1016/j.rpth.2025.102867","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>In patients with pulmonary embolism (PE), identifying predictors of recurrence is important to risk-stratify patients and tailor anticoagulation duration. After PE, a significant proportion of patients demonstrate residual pulmonary vascular obstruction (RPVO) on lung imaging. However, the exact prognostic significance of RPVO for venous thromboembolism recurrence remains unclear.</div></div><div><h3>Objectives</h3><div>The primary objective is to assess whether RPVO on ventilation/perfusion (V/Q) single photon emission computed tomography (SPECT)/CT imaging after completion of 3 to 6 months of anticoagulation is an independent predictor of venous thromboembolism recurrence in patients with PE.</div></div><div><h3>Methods</h3><div>The PRONOSPECT trial is a prospective multicenter cohort study. Participants are patients who experienced an objectively proven PE, provoked by a minor transient risk factor or unprovoked; who have been treated with anticoagulant therapy for 3 to 6 uninterrupted months; and for whom anticoagulation will not be prolonged. A standardized baseline patient assessment will be conducted including V/Q SPECT/CT imaging, collection of other potential predictor variables, and a functional evaluation. Anticoagulants will be withdrawn at the 3- or 6-month points from diagnosis and patients will be followed up for up to 2 years.</div></div><div><h3>Conclusion</h3><div>The PRONOSPECT cohort study has the potential to determine whether the presence of RPVO on V/Q SPECT/CT imaging predicts the risk of recurrence in patients with PE in whom there remains a doubt on duration of anticoagulation.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 3","pages":"Article 102867"},"PeriodicalIF":3.4000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Residual pulmonary vascular obstruction computed with ventilation/perfusion single photon emission computed tomography/computed tomography to predict the risk of venous thromboembolism recurrence in patients with pulmonary embolism: protocol for a cohort study (PRONOSPECT)\",\"authors\":\"Pierre–Yves Le Roux , Philippe Robin , Romain Le Pennec , Cécile Tromeur , Francis Couturaud , Julien Asselineau , Grégoire Le Gal , Pierre–Yves Salaun\",\"doi\":\"10.1016/j.rpth.2025.102867\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>In patients with pulmonary embolism (PE), identifying predictors of recurrence is important to risk-stratify patients and tailor anticoagulation duration. After PE, a significant proportion of patients demonstrate residual pulmonary vascular obstruction (RPVO) on lung imaging. However, the exact prognostic significance of RPVO for venous thromboembolism recurrence remains unclear.</div></div><div><h3>Objectives</h3><div>The primary objective is to assess whether RPVO on ventilation/perfusion (V/Q) single photon emission computed tomography (SPECT)/CT imaging after completion of 3 to 6 months of anticoagulation is an independent predictor of venous thromboembolism recurrence in patients with PE.</div></div><div><h3>Methods</h3><div>The PRONOSPECT trial is a prospective multicenter cohort study. Participants are patients who experienced an objectively proven PE, provoked by a minor transient risk factor or unprovoked; who have been treated with anticoagulant therapy for 3 to 6 uninterrupted months; and for whom anticoagulation will not be prolonged. A standardized baseline patient assessment will be conducted including V/Q SPECT/CT imaging, collection of other potential predictor variables, and a functional evaluation. Anticoagulants will be withdrawn at the 3- or 6-month points from diagnosis and patients will be followed up for up to 2 years.</div></div><div><h3>Conclusion</h3><div>The PRONOSPECT cohort study has the potential to determine whether the presence of RPVO on V/Q SPECT/CT imaging predicts the risk of recurrence in patients with PE in whom there remains a doubt on duration of anticoagulation.</div></div>\",\"PeriodicalId\":20893,\"journal\":{\"name\":\"Research and Practice in Thrombosis and Haemostasis\",\"volume\":\"9 3\",\"pages\":\"Article 102867\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Research and Practice in Thrombosis and Haemostasis\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2475037925001918\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Research and Practice in Thrombosis and Haemostasis","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2475037925001918","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}
Residual pulmonary vascular obstruction computed with ventilation/perfusion single photon emission computed tomography/computed tomography to predict the risk of venous thromboembolism recurrence in patients with pulmonary embolism: protocol for a cohort study (PRONOSPECT)
Background
In patients with pulmonary embolism (PE), identifying predictors of recurrence is important to risk-stratify patients and tailor anticoagulation duration. After PE, a significant proportion of patients demonstrate residual pulmonary vascular obstruction (RPVO) on lung imaging. However, the exact prognostic significance of RPVO for venous thromboembolism recurrence remains unclear.
Objectives
The primary objective is to assess whether RPVO on ventilation/perfusion (V/Q) single photon emission computed tomography (SPECT)/CT imaging after completion of 3 to 6 months of anticoagulation is an independent predictor of venous thromboembolism recurrence in patients with PE.
Methods
The PRONOSPECT trial is a prospective multicenter cohort study. Participants are patients who experienced an objectively proven PE, provoked by a minor transient risk factor or unprovoked; who have been treated with anticoagulant therapy for 3 to 6 uninterrupted months; and for whom anticoagulation will not be prolonged. A standardized baseline patient assessment will be conducted including V/Q SPECT/CT imaging, collection of other potential predictor variables, and a functional evaluation. Anticoagulants will be withdrawn at the 3- or 6-month points from diagnosis and patients will be followed up for up to 2 years.
Conclusion
The PRONOSPECT cohort study has the potential to determine whether the presence of RPVO on V/Q SPECT/CT imaging predicts the risk of recurrence in patients with PE in whom there remains a doubt on duration of anticoagulation.