Clinical Research Directory

Pulmonary Embolism Registry From Emergency to Long-Term Follow-Up and Surveillance

Acute pulmonary embolism (PE) is a leading cardiovascular cause of emergency department admission and mortality worldwide. While existing registries have described general epidemiological trends and outpatient anticoagulation patterns, there remains a critical evidence gap regarding granular clinical presentation, acute pre-hospital and emergency care, dynamic bedside reassessment, and their direct impact on long-term patient outcomes. The PERSEUS Registry (Pulmonary Embolism Registry from Short-term Emergency to long-term follow-Up and Surveillance) is an academic, investigator-initiated, multicenter, ambispective (combining retrospective and prospective cohorts), non-interventional observational registry. Promoted by Azienda Ospedaliero-Universitaria Careggi (Florence, Italy) in collaboration with a national and international hospital network, the registry enrolls consecutive adult patients presenting with objectively confirmed acute PE across emergency departments, high-dependency units, and inpatient wards. The primary objective of PERSEUS is to systematically characterize real-world clinical management and major adverse outcomes across the entire continuum of care-from pre-hospital and initial emergency department triage through dynamic in-hospital serial reassessment (T1-T4 intervals) and long-term follow-up (up to 5 years). The registry provides an extensive, high-quality centralized data infrastructure to: 1. Determine the contemporary incidence of 30-day all-cause and PE-related mortality, hemodynamic decompensation, recurrent venous thromboembolism (VTE), major bleeding (according to ISTH criteria), and chronic thromboembolic pulmonary hypertension (CTEPH); 2. Externally validate and compare clinical risk-stratification models and prognostic scoring systems (including the TELOS-plus score, simplified PESI, Bova score, ESC 2019 guidelines, and the AHA/ACC 2026 clinical classification); 3. Evaluate the real-world clinical effectiveness and safety of reperfusion therapies (systemic thrombolysis, catheter-directed therapies, and surgical embolectomy) in normotensive intermediate-high risk and hemodynamically unstable patients. Being strictly observational and non-interventional, patient management is conducted entirely according to routine clinical practice, local protocols, and international clinical guidelines, with no study-mandated interventions or diagnostic tests.

Prospective Cohort of Acute Cardiology Referrals in an Ambulatory Day-Hospital Setting

Suspected acute or subacute cardiovascular diseases-including chest pain, dyspnea, and palpitations-are among the most common reasons for unscheduled emergency department visits and pre-hospital referrals. Despite this high clinical burden, the diagnostic yield is often limited, with a frequent mismatch between initial clinical suspicion and final diagnosis, contributing to substantial healthcare utilization and hospitalization rates. Current evidence is largely focused on specific conditions such as acute coronary syndromes, heart failure, arrhythmias, or pulmonary embolism, and rarely integrates the full spectrum of clinical, biological, and imaging data obtained during initial evaluation. To address this gap, we will establish a prospective cohort of all consecutive patients referred to the ambulatory day-hospital cardiology unit at Lariboisière University Hospital. This unit acts as a specialized downstream referral structure within the emergency care pathway, receiving patients after triage by emergency physicians, pre-hospital regulation services (SAMU), mobile intensive care units (SMUR), or emergency departments. Although it does not capture all suspected cardiovascular emergencies, it represents a selected real-world population deemed to require specialized acute cardiology assessment. The primary objective is to assess the frequency of cardiac conditions diagnosed in this cohort. Secondary objectives include characterization of patient profiles and diagnostic pathways; evaluation of the diagnostic and prognostic performance of clinical, biological, imaging, and multimodal parameters using final Heart Team diagnosis as reference; analysis of prior health history and healthcare utilization; and assessment of the medico-economic burden of suspected acute cardiovascular disease. The study will further support the development of a dedicated biobank and the validation of next-generation biomarkers, including AI-driven and voice-based markers, as well as decision-support algorithms for binary classification of cardiac involvement. Through integration of multimodal data and linkage with national health records, this approach aims to improve diagnostic accuracy, risk stratification, and understanding of the healthcare impact of acute cardiovascular presentations in a real-world setting.