Background: The choice of the imaging modality for diagnosis of pulmonary embolism (PE) could be influenced by provider, patient or hospital characteristics, or over time. However, little is known about the choice of the diagnostic modalities in practice. The aim of this study was to evaluate the variations in the use of imaging modalities for patients with acute PE. Methods: Using the data from Registro Informatizado Enfermedad TromboEmbolica (RIETE), a prospective international registry of patients with venous thromboembolism (March 2001–January 2019), we explored the imaging modalities used in patients with acute PE. The imaging modalities included computed tomography pulmonary angiography, ventilation/perfusion scanning, pulmonary angiography, a combination of these tests, or PE signs and symptoms plus imaging-confirmed proximal deep vein thrombosis but no chest imaging. Results: Among 38 025 patients with confirmed PE (53.1% female, age: 67.3±17 years), computed tomography pulmonary angiography was the dominant modality of diagnosis in all RIETE enrollees (78.2% [99% CI, 77.6–78.7]); including pregnant patients (58.9% [99% CI, 47.7%–69.4%]) and patients with severe renal insufficiency (62.5% [99% CI, 59.9–65.0]). A greater proportion of patients underwent ventilation/perfusion scanning in larger hospitals compared with smaller hospitals (13.1% versus 7.3%, P <0.001). The use of computed tomography pulmonary angiography varied between 13.3% and 98.3% across the countries, and its use increased over time (46.5% in 2002 to 91.7% in 2018, P <0.001). Conclusions: In a large multinational PE registry, variations were observed in the use of imaging modalities according to patient or institutional factors and over time. However, computed tomography pulmonary angiography was the dominant modality of diagnosis, even in pregnancy and severe renal insufficiency. The safety, costs, and downstream effects of these tests on PE-related and non-PE-related outcomes warrant further investigation.

Pulmonary angiography

Computed Tomography Angiography

Modalities

10.1161/circimaging.120.010651

Cite

Citations (12)

Shaping current European mitochondrial haplogroup frequency in response to infection: the case of SARS-CoV-2 severity

Communications Biology (2025)

José Luis Cabrera-Alarcón Raquel Cruz Marina Rosa-Moreno Ana Latorre Silvia Diz‐de Almeida

The frequency of mitochondrial DNA haplogroups (mtDNA-HG) in humans is known to be shaped by migration and repopulation. Mounting evidence indicates that mtDNA-HG are not phenotypically neutral, and selection may contribute to its distribution. Haplogroup H, the most abundant in Europe, improved survival in sepsis. Here we developed a random forest trained model for mitochondrial haplogroup calling using data procured from GWAS arrays. Our results reveal that in the context of the SARS-CoV-2 pandemic, HV branch were found to represent protective factors against the development of critical SARS-CoV-2 in an analysis of 14,349 patients. These results highlight the role of mtDNA in the response to infectious diseases and support the proposal that its expansion and population proportion has been influenced by selection through successive pandemics. Genetic and Structural analysis of COVID patients cohort reveals a correlation between mitochondrial haplogroup and SARS-CoV-2 severity.

Haplogroup

Pandemic

10.1038/s42003-024-07314-y

Cite

Citations (0)

Outcomes of venous thromboembolism in patients with inherited thrombophilia treated with direct oral anticoagulants: insights from the RIETE registry

Journal of Thrombosis and Thrombolysis (2024)

Omri Cohen Gili Kenet Sarina Levy‐Mendelovich Inna Tzoran Benjamin Brenner

Protein C deficiency

Edoxaban

10.1007/s11239-024-02957-4

Cite

Citations (3)

Historia natural de la enfermedad tromboembólica venosa en el área mediterránea. Una revisión sistemática

Revista Clínica Española (2014)

Juan Francisco Sánchez Muñoz-Torrero A. Lorenzo-Hernández Javier Trujillo‐Santos Carmen Fernández‐Capitán José Luis Zamorano

10.1016/j.rce.2014.01.014

Cite

Citations (2)

Comparative clinical prognosis of massive and non‐massive pulmonary embolism: A registry‐based cohort study

Journal of Thrombosis and Haemostasis (2020)

Marc Blondon David Jiménez Helia Robert‐Ebadi J. del Toro Luciano López-Jiménez

10.1111/jth.15146

Cite

Citations (16)

Venous thromboembolism characteristics, treatment and outcomes in young adults: findings from the Registro Informatizado de Enfermedad TromboEmbólica registry

Journal of Thrombosis and Haemostasis (2023)

Omri Cohen Assaf Arie Barg Ulrike Nowak‐Göttl Cristina Amado-Fernández Lucia Mazzolai

10.1016/j.jtha.2023.06.031

Cite

Citations (3)

Symptomatic subsegmental versus more central pulmonary embolism: Clinical outcomes during anticoagulation

Research and Practice in Thrombosis and Haemostasis (2020)

Carmen Fernández‐Capitán Ana Rodríguez Cobo David Jiménez Olga Madridano Maurizio Ciammaichella

The optimal therapy of patients with acute subsegmental pulmonary embolism (PE) is controversial.

10.1002/rth2.12446

Cite

Citations (20)

Screening Protocol and Prevalence of Venous Thromboembolic Disease in Hospitalized Patients With COVID‐19

Journal of Ultrasound in Medicine (2021)

Jorge Álvarez Troncoso Luis Ramos‐Ruperto Pelayo Fernández‐Cidón Elena Trigo Yale Tung‐Chen

Background SARS‐CoV‐2 disease (COVID‐19) induces endothelial damage and sustained hypoxia and facilitates immobilization as factors of hypercoagulability. Objectives The objective of our study was to assess the prevalence of venous thromboembolic disease (VTD) in COVID‐19 patients and the usefulness of VTD screening based on age‐adjusted D‐dimer and point‐of‐care ultrasound (POCUS). Patients/Methods We conducted a single cohort, prospective observational study in 102 consecutive hospitalized patients. Results A total of 102 POCUS and 39 pulmonary computed tomography angiography (PCTA) were performed diagnosing 27 VTD (26.5%): 17 deep vein thrombosis (DVT) (16.6% positive POCUS) and 18 pulmonary embolism (PE) (46.2% positive PCTA). COVID‐19 patients with VTD were older ( P < .030), had higher D‐dimer ( P < .001), higher International Society on Thrombosis and Hemostasis score ( P < .001), and higher mortality ( P = .025). However, there were no differences in inflammatory laboratory parameters neither in the cytokine storm syndrome (CSS) development. The ROC curve for D‐dimer showed an AUC of 0.91. We have evidenced that patients with D‐dimer between 2000 and 6000 ng/mL could benefit from a screening strategy with POCUS given the high sensitivity and specificity of the test. Furthermore, patients with D‐dimer ≥6000 ng/mL should undergo POCUS and PCTA to rule out DVT and PE, respectively. Conclusions In our cohort, 26.5% of the patients presented VTD. Screening strategy based on age‐adjusted D‐dimer and POCUS proved high sensitivity and specificity. Future trials focused on screening strategies are necessary to early detect the presence of DVT and PE and determine thromboprophylaxis strategies in patients with COVID‐19.

D-dimer

10.1002/jum.15850

Cite

Citations (3)

Analysis of noncatheter-associated upper extremity deep venous thrombosis from the RIETE registry

Journal of Vascular Surgery Venous and Lymphatic Disorders (2016)

Daniel H. Newton Manuel Monreal Bosch Michael Amendola Luke G. Wolfe Cristina Pérez Ductor

10.1016/j.jvsv.2016.08.002

Cite

Citations (17)