{
  "abstract": "Background\n\nThere are ongoing efforts to identify patients at risk of chronic thromboembolic pulmonary hypertension (CTEPH) during acute pulmonary embolism (APE). Lower D-dimer levels and right heart overload at APE diagnosis were reported to predict CTEPH. We hypothesised that plasma D-dimer to N-terminal pro-B type natriuretic peptide (NT-proBNP) ratio assessed during APE may be useful for early CTEPH screening.Methods\n\nWe followed 342 APE survivors (median age 64.5 years, female 56.1%), for a median of 39 (25-64) months.Results\n\nDespite ≥3 months anticoagulation CTEPH was diagnosed in 22 (6.4%) patients (CTEPH(+)). At APE diagnosis, CTEPH(+) compared with subjects without this sequela (CTEPH(-)) presented with advanced right ventricular overload: increased tricuspid regurgitation peak gradient (TRPG) (46.5 mmHg versus 32.0 mmHg; p<0.001) and NT-proBNP (1860 ng·L⁻¹ versus 515 ng·L⁻¹; p=0.02). Despite no differences in plasma D-dimer (4210 μg·L⁻¹ versus 5330 μg·L⁻¹; p=0.10), the ratio of D-dimer to NT-proBNP (DD/NT-proBNP) was significantly lower in the CTEPH(+) cohort versus the CTEPH(-) cohort (2.89 μg·ng⁻¹ versus 12.0 μg·ng⁻¹; p<0.001). In patients with DD/NT-proBNP≤10 CTEPH was diagnosed in 20 cases (11.7%), whereas in the group with DD/NT-proBNP> 10 CTEPH could only be detected in 2 of 171 cases (1.2%) with an OR 0.09 (95% confidence interval (CI) 0.02-0.38; p=0.0013), a sensitivity of 90.9% (95% CI 70.8-98.9%), a specificity 52.8% (95% CI 47.2-58.4%), a negative predictive value 98.8% (95% CI 95.8-99.9%), a and positive predictive value of 11.7% (95% CI 7.3-17.5%). Combination of DD/NT-proBNP≤10 with TRPG≥36 mmHg detected in 87 patients, including 17 patients with CTEPH (19.5% CTEPH incidence).Conclusion\n\nDD/NT-proBNP>10 μg·ng⁻¹ identifies patients with a low risk of subsequent CTEPH diagnosis, whereas DD/NT-proBNP≤10, especially presenting TRPG≥36 mmHg at echocardiography, forms a high risk group at follow-up.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Internal Medicine and Cardiology, Center for Management of Venous Thromboembolic Disease, Medical University of Warsaw, Warsaw, Poland.",
    "These authors contributed equally to this work.",
    "Department of Radiology, Medical University of Warsaw, Warsaw, Poland."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Katarzyna Spychalska"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Mateusz Jermakow",
      "orcid": "0000-0002-2438-9677"
    },
    {
      "affs": [
        0
      ],
      "name": "Joanna Kucharska"
    },
    {
      "affs": [
        0
      ],
      "name": "Olga Dzikowska-Diduch",
      "orcid": "0000-0002-8132-1660"
    },
    {
      "affs": [
        0
      ],
      "name": "Katarzyna Perzanowska-Brzeszkiewicz"
    },
    {
      "affs": [
        0
      ],
      "name": "Iwona Dudzik-Niewiadomska"
    },
    {
      "affs": [
        0
      ],
      "name": "Andrzej Łabyk"
    },
    {
      "affs": [
        0
      ],
      "name": "Aisha Ou-Pokrzewińska"
    },
    {
      "affs": [
        2
      ],
      "name": "Małgorzata Wiśniewska"
    },
    {
      "affs": [
        0
      ],
      "name": "Marek Roik"
    },
    {
      "affs": [
        0
      ],
      "name": "Ciurzyński Michał"
    },
    {
      "affs": [
        0
      ],
      "name": "Piotr Pruszczyk",
      "orcid": "0000-0002-9768-0000"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/83hhx4hs02x9m.bib",
  "cited_by": 0,
  "doi": "10.1183/23120541.00580-2026",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13725833/?tool=EBI",
  "id": "83hhx4hs02x9m",
  "issns": [
    "2312-0541"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13725833",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "7"
    ],
    [
      "heading",
      "Original Research Article"
    ],
    [
      "heading",
      "Pulmonary Vascular Diseases"
    ],
    [
      "openalex",
      "2724|Venous Thromboembolism Diagnosis and Management"
    ]
  ],
  "openalex": "W7170188570",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13725833/pdf/?tool=EBI",
  "pmcid": "PMC13725833",
  "pmid": "42974014",
  "published": "2026-11-01",
  "publisher": "European Respiratory Society",
  "ris": "https://research.draconitic.com/paper/83hhx4hs02x9m.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T15:20:51Z",
      "native_id": "PMC:PMC13725833",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13725833"
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    {
      "first_seen": "2026-11-04T15:20:47Z",
      "native_id": "MED:42974014",
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      "url": "https://europepmc.org/article/MED/42974014"
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    {
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      "native_id": "PMC13725833",
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      "url": "https://doi.org/10.1183/23120541.00580-2026"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2724|Venous Thromboembolism Diagnosis and Management",
      "subfield": "general"
    }
  ],
  "title": "D-dimer/NT-proBNP ratio in acute pulmonary embolism patients stratifies risk of chronic thromboembolic pulmonary hypertension",
  "title_text": "D-dimer/NT-proBNP ratio in acute pulmonary embolism patients stratifies risk of chronic thromboembolic pulmonary hypertension",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T12:21:55Z",
  "url": "https://research.draconitic.com/paper/83hhx4hs02x9m",
  "venue": "ERJ open research",
  "versions": []
}