Venous Thromboembolism (VTE)PERSEUSNCT07855679
Pulmonary Embolism Registry From Short-Term Emergency to Long-Term Follow-Up and Surveillance
An observational study of Venous Thromboembolism (VTE) and Chronic Thromboembolic Pulmonary Hypertension, run by Azienda Ospedaliero-Universitaria Careggi at 16 sites in 3 countries.
Trial summary
PERSEUS is an academic, investigator-initiated, multicenter observational registry of adults with acute pulmonary embolism (PE), promoted by Azienda Ospedaliero-Universitaria Careggi (Florence, Italy). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Venous Thromboembolism (VTE), Chronic Thromboembolic Pulmonary Hypertension, Right Ventricular Dysfunction
- What is being tested?
- Routine clinical care (no study intervention)
- How many people
- 5,000 participants
- Where
- 16 sitesin 3 countries
- Study dates
- 19 Jun 2026to Jul 2032
- How long will I take part?
- 5 Years
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Consecutive adults with objectively confirmed acute pulmonary embolism diagnosed at participating hospitals, from emergency department presentation through hospitalization, including patients presenting with obstructive shock or cardiac arrest.
Who may be able to join
- Age 18 years or older at the time of presentation.
- Objectively confirmed diagnosis of acute pulmonary embolism (PE), with or without concomitant deep vein thrombosis (DVT) of the lower or upper extremities, confirmed by at least one of the following methods:
- Computed tomography pulmonary angiography (CTPA) demonstrating intraluminal filling defects in the pulmonary arterial tree;
- Ventilation/perfusion (V/Q) lung scintigraphy demonstrating high-probability mismatch;
- Conventional catheter-directed pulmonary angiography;
- In hemodynamically unstable patients (obstructive shock or cardiac arrest) in whom definitive imaging is not feasible: bedside point-of-care ultrasound showing clear signs of right ventricular overload together with proximal deep vein thrombosis, or mobile right heart thrombi.
- For the retrospective cohort: availability of medical records documenting clinical presentation and index diagnostic work-up at baseline (T0). The absence of serial reassessment timepoints (T1-T4) does not constitute an exclusion criterion.
- Written informed consent obtained from the patient or legal surrogate, or waiver/exception under Article 110-bis of the Italian Privacy Code (and applicable institutional ethical clearance) for deceased or untraceable patients.
Who cannot join
- Current active enrollment in an interventional experimental drug trial (blinded randomized clinical trial) where active drug allocation or protocol-mandated therapeutic regimen is unknown.
Trial locations and contacts
16 sites in 3 countries. Contact the study team or a site near you to ask about taking part.
16 sites in 3 countries
Italy14 sites, 14 recruiting
- Recruiting
Ospedale Santa Maria Annunziata - Azienda USL Toscana Centro
Bagno a Ripoli, Tuscany, 50012
Germana Ruggiano, MD, +39 055 69361, germana.ruggiano@uslcentro.toscana.it
- Recruiting
Nuovo Ospedale del Mugello - Azienda USL Toscana Centro
Borgo San Lorenzo, Tuscany, 50032
Leonardo Delli, MD, +39 055 84511, leonardo.delli@uslcentro.toscana.it
- Recruiting
Ospedale San Giuseppe - Azienda USL Toscana Centro
Empoli, Tuscany, 50053
Paola Bartalucci, MD, +39 0571 7051, paola.bartalucci@uslcentro.toscana.it
- Recruiting
Ospedale Santa Maria Nuova - Azienda USL Toscana Centro
Florence, Tuscany, 50122
Michele Lanigra, MD, +39 055 69381, michele.lanigra@uslcentro.toscana.it
- Recruiting
Azienda Ospedaliero-Universitaria Careggi
Florence, Tuscany, 50134
Simone Vanni, MD, PhD, +393666904459, simone.vanni@unifi.it
Matteo Gabriele Monda, MD, +393209433394, matteogabriele.monda@gmail.com
- Recruiting
Ospedale San Giovanni di Dio (Torregalli) - Azienda USL Toscana Centro
Florence, Tuscany, 50143
Gianfranco Giannasi, MD, +39 055 69321, gianfranco.giannasi@uslcentro.toscana.it
- Recruiting
Ospedale Versilia - Azienda USL Toscana Nord Ovest
Lido di Camaiore
Gisueppe Pepe, MD, +3905846051, giuseppe.pepe@uslnordovest.toscana.it
Giuseppe Pepe, MD
- Recruiting
AORN Antonio Cardarelli
Naples, 80131
Angela Iannuzzi, MD, +390817471111, angela.iannuzzi@aocardarelli.it
Angela Iannuzzi, MD
- Recruiting
Azienda Ospedaliera di Perugia - Ospedale Santa Maria della Misericordia
Perugia, 06129
Cecilia Becattini, MD, PhD, +390755781, cecilia.becattini@unipg.it
Cecilia Becattini, MD, PhD
- Recruiting
Ospedale Santi Cosma e Damiano - Azienda USL Toscana Centro
Pescia, Tuscany, 51017
Gianluca Buffini, MD, +39 0572 4601, gianluca.buffini@uslcentro.toscana.it
- Recruiting
Azienda Ospedaliero-Universitaria Pisana - Ospedale Cisanello
Pisa
Lorenzo Ghiadoni, MD, PhD, +39050992111, lorenzo.ghiadoni@unipi.it
Lorenzo Ghiadoni, MD, PhD
- Recruiting
Ospedale San Jacopo - Azienda USL Toscana Centro
Pistoia, Tuscany, 51100
Mirco Donati, MD, +39 0573 3521, mirco.donati@uslcentro.toscana.it
- Recruiting
Ospedale Santo Stefano - Azienda USL Toscana Centro
Prato, Tuscany, 59100
Matteo Gabriele Monda, MD, +393209433394, matteogabriele.monda@gmail.com
matteogabriele.monda@gmail.com
- Recruiting
AOU Città della Salute e della Scienza di Torino - Presidio Molinette
Torino, 10126
Fulvio Morello, MD, +390116335555, fulvio.morello@unito.it
Fulvio Morello, MD
Poland1 site, 1 recruiting
- Recruiting
Medical University of Warsaw - Infant Jesus Teaching Hospital
Warsaw
Piotr Pruszczyk, MD, PhD, +48225021000, piotr.pruszczyk@wum.edu.pl
Piotr Pruszczyk, MD, PhD
Spain1 site, 1 recruiting
- Recruiting
Hospital Universitario Ramón y Cajal
Madrid
David Jiménez, MD, PhD, +34913368000, djimenez.hrc@gmail.com
David Jiménez, MD, PhD
About this study
Official title: The PERSEUS Registry - Pulmonary Embolism Registry From Short-Term Emergency to Long-Term Follow-Up and Surveillance
PERSEUS is an academic, investigator-initiated, multicenter observational registry of adults with acute pulmonary embolism (PE), promoted by Azienda Ospedaliero-Universitaria Careggi (Florence, Italy). It collects data generated during routine care across the whole course of the disease: pre-hospital care when available, emergency department presentation, the hospital stay (including bedside reassessments in the first 48 hours when performed as part of care) and follow-up up to 5 years. The registry has a retrospective cohort (patients diagnosed from 1 January 2023 until local ethics committee approval, with data taken from medical records) and a prospective cohort (consecutive patients enrolled after approval). Taking part in the registry does not change patient care: all tests and treatments are decided by the treating physicians. The registry aims to describe how acute PE is managed in everyday practice and how often patients die (from any cause and from PE), deteriorate hemodynamically, have recurrent venous thromboembolism or bleeding, and develop long-term complications such as chronic thromboembolic pulmonary hypertension. The database also supports ancillary analyses with separate pre-specified analysis plans, such as the evaluation of existing risk-stratification tools.
Read the detailed description
BACKGROUND AND SCIENTIFIC RATIONALE
Pulmonary embolism (PE) represents a major cause of emergency department (ED) presentation, critical care admission, and early mortality. Despite advances in diagnostic algorithms and therapeutic strategies, intermediate- and high-risk PE patients remain challenging to risk-stratify dynamically during the acute phase. Current prognostic tools often rely solely on baseline single-point parameters, neglecting acute pathophysiological changes during the initial 48 hours of treatment. The PERSEUS Registry is designed to bridge this gap by capturing comprehensive, granular real-world data spanning the acute presentation, dynamic in-hospital course, and long-term surveillance.
STUDY DESIGN AND COHORTS
Time perspective: ambispective (retrospective and prospective cohorts, described below).
PERSEUS is an observational, ambispective, multicenter registry comprising two distinct phases:
- Retrospective Phase (Historical Cohort): Includes consecutive adult patients diagnosed with acute PE from January 1, 2023, up to the date of local Ethics Committee approval at each participating site. Data are abstracted from medical records.
- Prospective Phase (Contemporary Cohort): Enrolls consecutive adult patients presenting with acute PE after local Ethics Committee approval, extending for a continuous enrollment period of 5 years. Data are collected during routine care.
STUDY SETTING AND CLINICAL CONTINUUM OF CARE
Data collection spans the entire continuum of clinical care across participating academic, tertiary, and regional hospitals:
- Baseline Presentation (T0): Captures pre-hospital emergency medical service (EMS) data (initial vital signs, cardiac arrest, point-of-care ultrasound [POCUS], pre-hospital anticoagulation or thrombolysis), ED arrival parameters, clinical symptoms, arterial blood gas analysis, admission laboratory biomarkers (high-sensitivity troponin, BNP/NT-proBNP, lactate, D-dimer, renal function), electrocardiographic patterns, and multiorgan diagnostic imaging (CT pulmonary angiography [CTPA], complete echocardiography/POCUS, and compression venous ultrasound [CUS]).
- Dynamic In-Hospital Reassessment (T1-T4): To capture real-world hemodynamic and respiratory trajectories, serial parameters documented during standard clinical monitoring are recorded across predefined temporal windows: T1 (3-6 hours), T2 (6-12 hours), T3 (12-24 hours), and T4 (24-48 hours). Parameters include serial vital signs, shock index, respiratory support modalities, serial lactate/troponin kinetics, echocardiographic right ventricular function changes, and need for escalating hemodynamic or respiratory support (vasopressors, inotropes, non-invasive ventilation, mechanical ventilation, or ECMO).
- Hospital Discharge \& Complications: Documents in-hospital adverse events, need for rescue reperfusion, procedural complications, bleeding events, length of stay, and vital status at discharge.
- Follow-up Surveillance: Thirty-day status is ascertained from clinical records. Follow-up then reflects routine care at 3 and 12 months and annually thereafter up to 5 years (in-person visit, telemedicine, telephone contact or review of clinical documentation), with regional mortality registries used to ascertain vital status when needed. Follow-up collects all-cause survival, cause of death, VTE recurrence, major and clinically relevant non-major bleeding, persistent functional limitation (modified Rankin Scale, exertional dyspnea, six-minute walk test when performed) and the development of chronic thromboembolic pulmonary hypertension (CTEPH).
OUTCOMES
Outcome definitions and time frames are reported in the Outcome Measures section.
DATA MANAGEMENT, QUALITY ASSURANCE, AND ETHICAL GOVERNANCE
Data collection is centralized using an electronic Case Report Form (eCRF) deployed on the REDCap (Research Electronic Data Capture) platform hosted on secure institutional servers at Azienda Ospedaliero-Universitaria Careggi (Florence, Italy).
- Privacy and Data Segregation: Strict GDPR compliance is maintained. Patient data are pseudonymized at source by the local site investigator using site-specific Subject IDs. The decoding key linking the alphanumeric ID to personal identifiers is maintained exclusively at the local participating hospital under the responsibility of the local Principal Investigator.
- Data Access Groups (DAGs): REDCap DAGs are enforced to compartmentalize site-level access, ensuring participating centers can exclusively view, enter, and edit their own center's records, with no unauthorized cross-center data visibility.
- Quality Assurance: The eCRF includes built-in validation rules (range and logic checks). The coordinating center performs regular central monitoring for inconsistencies, outliers and missing data, and discrepancies are resolved with each center through a formal query process. The Steering Committee reviews enrollment, data quality and protocol adherence every 6 months.
- Regulatory Framework: Protocol version 2.0 (7 May 2026) received a favourable opinion from the Comitato Etico Regione Toscana - Area Vasta Centro (CEAVC, register no. 30742_oss, meeting of 9 June 2026) for the sites of Azienda Ospedaliero-Universitaria Careggi and Azienda USL Toscana Centro. Participation of other national and international centers is subject to approval of a protocol amendment and of the competent local ethics committees. The study is conducted in accordance with the Declaration of Helsinki, Good Clinical Practice principles and applicable privacy regulations (including Article 110-bis of the Italian Privacy Code).
- Conditions
- Venous Thromboembolism (VTE), Chronic Thromboembolic Pulmonary Hypertension, Right Ventricular Dysfunction, Pulmonary Embolism (PE)
- Being tested
- Routine clinical care (no study intervention)
- Keywords
- Pulmonary Embolism, Acute Pulmonary Embolism, Venous Thromboembolism, Right Ventricular Dysfunction, Risk Stratification, Prognostic Scores, TELOS-plus, sPESI, Bova Score, ESC Guidelines, AHA/ACC Guidelines, High-Sensitivity Troponin, Plasma Lactate, Echocardiography, CT Pulmonary Angiography, Hemodynamic Decompensation, Systemic Thrombolysis, Catheter-Directed Therapy, Observational Registry, Real-World Evidence
- Medical subject headings
- Venous Thromboembolism, Ventricular Dysfunction, Right, Pulmonary Embolism, Emergencies, Heart Arrest
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Routine clinical care (no study intervention)Other
Also called Routine Clinical Practice, Usual Care
Observational registry. Diagnostic and therapeutic management (laboratory tests, imaging, bedside ultrasound, anticoagulation, reperfusion and hemodynamic support) is entirely at the discretion of the treating physicians, according to routine institutional pathways and international guidelines. The registry only collects data generated in routine care.
| Study group | Role | What they receive |
|---|---|---|
| Adults with acute pulmonary embolism | Consecutive adults with objectively confirmed acute pulmonary embolism, in two cohorts: a retrospective cohort (diagnoses from 1 January 2023 until local ethics committee approval; data abstracted from medical records) and a prospective cohort (consecutive enrollment after approval, for 5 years; data collected during routine care). Receives: Other: Routine clinical care (no study intervention) |
What is being measured
The primary outcome is the main question the study is designed to answer.
All-cause mortality at 30 days
Proportion of patients who die from any cause within 30 days of the objectively confirmed diagnosis of acute pulmonary embolism. Vital status is ascertained from hospital records, review of clinical documentation and, when needed, regional mortality registries.
Measured: 30 days after diagnosis
PE-related mortality at 30 days
Proportion of patients whose death within 30 days is adjudicated as a direct consequence of the index or a recurrent pulmonary embolism (PE). Fatal PE is defined as death occurring after objectively confirmed PE (index or recurrent event) in the absence of other identifiable causes, or confirmed at autopsy. For deaths occurring at home, information on the cause of death is actively sought.
Measured: 30 days after diagnosis
Secondary outcomes (8)
Hemodynamic decompensation
Proportion of patients with new occurrence, after the initial assessment, of at least one of: persistent hypotension (systolic blood pressure <90 mmHg for 15 minutes or longer) or shock; need for continuous vasopressor or inotrope infusion; invasive mechanical ventilation; cardiac arrest; rescue reperfusion therapy (systemic, catheter-directed or surgical) for clinical deterioration. Reperfusion given as the initial treatment strategy is not counted as an event.
Measured: From diagnosis to hospital discharge or day 30, whichever comes first
All-cause mortality during follow-up
Proportion of patients who die from any cause during follow-up.
Measured: 3 months, 12 months, and annually up to 5 years after diagnosis
PE-related mortality during follow-up
Proportion of patients whose death during follow-up is adjudicated as a direct consequence of the index or a recurrent pulmonary embolism, as defined for the 30-day PE-related mortality outcome.
Measured: 3 months, 12 months, and annually up to 5 years after diagnosis
Recurrent venous thromboembolism
Proportion of patients with any new episode of pulmonary embolism or deep vein thrombosis (lower or upper limb, proximal or distal) confirmed by objective testing. Superficial vein thrombosis is not counted.
Measured: 30 days, 3 months, 12 months, and annually up to 5 years after diagnosis
Major bleeding (ISTH criteria)
Proportion of patients with major bleeding according to the International Society on Thrombosis and Haemostasis (ISTH): overt bleeding that is fatal; or occurs in a critical area or organ (intracranial, intraspinal, intraocular, retroperitoneal, intra-articular, pericardial, or intramuscular with compartment syndrome); or causes a fall in hemoglobin of 2 g/dL (1.24 mmol/L) or more, or leads to transfusion of two or more units of whole blood or red cells. Major bleeding is additionally classified as life-threatening if it is extracranial bleeding causing shock or intracranial hemorrhage with a Glasgow Coma Scale score below 14.
Measured: 30 days, 3 months, 12 months, and annually up to 5 years after diagnosis
Clinically relevant non-major bleeding
Proportion of patients with bleeding not meeting the criteria for major bleeding but requiring medical intervention, unscheduled contact with a physician, or temporary cessation of antithrombotic therapy.
Measured: 30 days, 3 months, 12 months, and annually up to 5 years after diagnosis
Chronic thromboembolic pulmonary hypertension (CTEPH)
Proportion of patients with CTEPH diagnosed during routine follow-up: mean pulmonary arterial pressure >20 mmHg, pulmonary arterial wedge pressure ≤15 mmHg and pulmonary vascular resistance >2 Wood units at right heart catheterization, with mismatched perfusion defects after at least 3 months of therapeutic anticoagulation (2022 ESC/ERS criteria). Diagnostic tests are performed only when clinically indicated.
Measured: 30 days, 3 months, 12 months, and annually up to 5 years after diagnosis
Persistent functional limitation after pulmonary embolism (post-PE syndrome)
Persistent or worsened exertional dyspnea compared with pre-event status, modified Rankin Scale score, and six-minute walk distance when performed in routine care.
Measured: 30 days, 3 months, 12 months, and annually up to 5 years after diagnosis
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Oct 2026
- Study start19 Jun 2026
- Primary completionJul 2031 (estimated)
- Study completionJul 2032 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (8)Papers the sponsor has linked to this study.
- Other trials for Venous Thromboembolism (VTE)Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Other
- Enrolment
- 5,000 participants (estimated)
- Target duration
- 5 Years
Sponsor and investigators
- Lead sponsor
- Azienda Ospedaliero-Universitaria Careggi
- Sponsor type
- University, hospital or other
- Collaborators
- University of Florence, Azienda USL Toscana Centro, Azienda Ospedaliera di Perugia, Cardarelli Hospital, Naples, Italy, Azienda Ospedaliero, Universitaria Pisana, Azienda USL Toscana Nord Ovest, Medical University of Warsaw, Hospital Universitario Ramon y Cajal, A.O.U. Città della Salute e della Scienza - Molinette Hospital
- Responsible party
- Principal investigator, Simone Vanni, Azienda Ospedaliero-Universitaria Careggi
- Investigators
- Simone Vanni, MD, PhD, Principal investigator, Azienda Ospedaliero-Universitaria Careggi / University of FlorenceMatteo Gabriele Monda, MD, Study director, Azienda Ospedaliero-Universitaria Careggi / University of Florence
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07855679
- Sponsor's protocol ID
- PERSEUS
- Other IDs
- 30742_oss
- Acronym
- PERSEUS
- Status last verified
- Oct 2026
- First submitted
- 28 Sep 2026
- Last updated
- 15 Oct 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Pseudonymized individual participant data underlying published results may be shared with qualified researchers for methodologically sound proposals that fall within the scientific scope of the registry and do not overlap with analyses planned by the PERSEUS investigators. Sharing requires approval by the PERSEUS Steering Committee, approval by the competent ethics committee and a data transfer agreement with Azienda Ospedaliero-Universitaria Careggi, in compliance with the GDPR and the Italian Privacy Code.
Publications
Barco S, Mahmoudpour SH, Valerio L, Klok FA, Munzel T, Middeldorp S, Ageno W, Cohen AT, Hunt BJ, Konstantinides SV. Trends in mortality related to pulmonary embolism in the European Region, 2000-15: analysis of vital registration data from the WHO Mortality Database. Lancet Respir Med. 2020 Mar;8(3):277-287. doi: 10.1016/S2213-2600(19)30354-6. Epub 2019 Oct 12.
PubMed 31615719Jimenez D, de Miguel-Diez J, Guijarro R, Trujillo-Santos J, Otero R, Barba R, Muriel A, Meyer G, Yusen RD, Monreal M; RIETE Investigators. Trends in the Management and Outcomes of Acute Pulmonary Embolism: Analysis From the RIETE Registry. J Am Coll Cardiol. 2016 Jan 19;67(2):162-170. doi: 10.1016/j.jacc.2015.10.060.
PubMed 26791063Goldhaber SZ, Visani L, De Rosa M. Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet. 1999 Apr 24;353(9162):1386-9. doi: 10.1016/s0140-6736(98)07534-5.
PubMed 10227218Heit JA. The epidemiology of venous thromboembolism in the community. Arterioscler Thromb Vasc Biol. 2008 Mar;28(3):370-2. doi: 10.1161/ATVBAHA.108.162545. No abstract available.
PubMed 18296591Humbert M, Kovacs G, Hoeper MM, Badagliacca R, Berger RMF, Brida M, Carlsen J, Coats AJS, Escribano-Subias P, Ferrari P, Ferreira DS, Ghofrani HA, Giannakoulas G, Kiely DG, Mayer E, Meszaros G, Nagavci B, Olsson KM, Pepke-Zaba J, Quint JK, Radegran G, Simonneau G, Sitbon O, Tonia T, Toshner M, Vachiery JL, Vonk Noordegraaf A, Delcroix M, Rosenkranz S; ESC/ERS Scientific Document Group. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J. 2022 Oct 11;43(38):3618-3731. doi: 10.1093/eurheartj/ehac237. No abstract available.
PubMed 36017548Franco L, Becattini C, Beyer-Westendorf J, Vanni S, Nitti C, Re R, Manina G, Pomero F, Cappelli R, Conti A, Agnelli G. Definition of major bleeding: Prognostic classification. J Thromb Haemost. 2020 Nov;18(11):2852-2860. doi: 10.1111/jth.15048. Epub 2020 Sep 11.
PubMed 32767653Vanni S, Pelagatti L, Caviglioli C, Fabiani G, Caldi F, Pellegrino A, Ottaviani M, Innocenti F, Nazerian P. TELOS-plus identifies normotensive patients with pulmonary embolism at high risk of 30-day mortality. Int J Cardiol. 2026 Feb 1;444:133974. doi: 10.1016/j.ijcard.2025.133974. Epub 2025 Oct 22.
PubMed 41135774Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing GJ, Harjola VP, Huisman MV, Humbert M, Jennings CS, Jimenez D, Kucher N, Lang IM, Lankeit M, Lorusso R, Mazzolai L, Meneveau N, Ni Ainle F, Prandoni P, Pruszczyk P, Righini M, Torbicki A, Van Belle E, Zamorano JL; ESC Scientific Document Group. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020 Jan 21;41(4):543-603. doi: 10.1093/eurheartj/ehz405. No abstract available.
PubMed 31504429
Study at a glance
From the registry record, last updated by the sponsor on 15 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The PERSEUS Registry - Pulmonary Embolism Registry From Short-Term Emergency to Long-Term Follow-Up and Surveillance
- ClinicalTrials.gov ID
- NCT07855679
- Acronym / sponsor ID
- PERSEUS / PERSEUS
- Conditions
- Venous Thromboembolism (VTE), Chronic Thromboembolic Pulmonary Hypertension, Right Ventricular Dysfunction, Pulmonary Embolism (PE)
- Keywords
- Pulmonary Embolism, Acute Pulmonary Embolism, Venous Thromboembolism, Right Ventricular Dysfunction, Risk Stratification, Prognostic Scores, TELOS-plus, sPESI
- Study type
- Observational
- Recruitment status
- Recruiting
- Enrolment
- 5,000 participants (estimated)
- Lead sponsor
- Azienda Ospedaliero-Universitaria CareggiUniversity, hospital or other
- Collaborators
- University of Florence, Azienda USL Toscana Centro, Azienda Ospedaliera di Perugia, Cardarelli Hospital, Naples, Italy, Azienda Ospedaliero, Universitaria Pisana, Azienda USL Toscana Nord Ovest, Medical University of Warsaw, Hospital Universitario Ramon y Cajal, A.O.U. Città della Salute e della Scienza - Molinette Hospital
- Study start
- 19 Jun 2026 (actual)
- Primary completion
- Jul 2031 (estimated)
- Study completion
- Jul 2032 (estimated)
- First posted
- 2 Oct 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
PERSEUS is an academic, investigator-initiated, multicenter observational registry of adults with acute pulmonary embolism (PE), promoted by Azienda Ospedaliero-Universitaria Careggi (Florence, Italy). It collects data generated during routine care across the whole course of the disease: pre-hospital care when available, emergency department presentation, the hospital stay (including bedside reassessments in the first 48 hours when performed as part of care) and follow-up up to 5 years. The registry has a retrospective cohort (patients diagnosed from 1 January 2023 until local ethics committee approval, with data taken from medical records) and a prospective cohort (consecutive patients enrolled after approval). Taking part in the registry does not change patient care: all tests and treatments are decided by the treating physicians. The registry aims to describe how acute PE is managed in everyday practice and how often patients die (from any cause and from PE), deteriorate hemodynamically, have recurrent venous thromboembolism or bleeding, and develop long-term complications such as chronic thromboembolic pulmonary hypertension. The database also supports ancillary analyses with separate pre-specified analysis plans, such as the evaluation of existing risk-stratification tools.
Detailed description
BACKGROUND AND SCIENTIFIC RATIONALE
Pulmonary embolism (PE) represents a major cause of emergency department (ED) presentation, critical care admission, and early mortality. Despite advances in diagnostic algorithms and therapeutic strategies, intermediate- and high-risk PE patients remain challenging to risk-stratify dynamically during the acute phase. Current prognostic tools often rely solely on baseline single-point parameters, neglecting acute pathophysiological changes during the initial 48 hours of treatment. The PERSEUS Registry is designed to bridge this gap by capturing comprehensive, granular real-world data spanning the acute presentation, dynamic in-hospital course, and long-term surveillance.
STUDY DESIGN AND COHORTS
Time perspective: ambispective (retrospective and prospective cohorts, described below).
PERSEUS is an observational, ambispective, multicenter registry comprising two distinct phases:
- Retrospective Phase (Historical Cohort): Includes consecutive adult patients diagnosed with acute PE from January 1, 2023, up to the date of local Ethics Committee approval at each participating site. Data are abstracted from medical records.
- Prospective Phase (Contemporary Cohort): Enrolls consecutive adult patients presenting with acute PE after local Ethics Committee approval, extending for a continuous enrollment period of 5 years. Data are collected during routine care.
STUDY SETTING AND CLINICAL CONTINUUM OF CARE
Data collection spans the entire continuum of clinical care across participating academic, tertiary, and regional hospitals:
- Baseline Presentation (T0): Captures pre-hospital emergency medical service (EMS) data (initial vital signs, cardiac arrest, point-of-care ultrasound [POCUS], pre-hospital anticoagulation or thrombolysis), ED arrival parameters, clinical symptoms, arterial blood gas analysis, admission laboratory biomarkers (high-sensitivity troponin, BNP/NT-proBNP, lactate, D-dimer, renal function), electrocardiographic patterns, and multiorgan diagnostic imaging (CT pulmonary angiography [CTPA], complete echocardiography/POCUS, and compression venous ultrasound [CUS]).
- Dynamic In-Hospital Reassessment (T1-T4): To capture real-world hemodynamic and respiratory trajectories, serial parameters documented during standard clinical monitoring are recorded across predefined temporal windows: T1 (3-6 hours), T2 (6-12 hours), T3 (12-24 hours), and T4 (24-48 hours). Parameters include serial vital signs, shock index, respiratory support modalities, serial lactate/troponin kinetics, echocardiographic right ventricular function changes, and need for escalating hemodynamic or respiratory support (vasopressors, inotropes, non-invasive ventilation, mechanical ventilation, or ECMO).
- Hospital Discharge \& Complications: Documents in-hospital adverse events, need for rescue reperfusion, procedural complications, bleeding events, length of stay, and vital status at discharge.
- Follow-up Surveillance: Thirty-day status is ascertained from clinical records. Follow-up then reflects routine care at 3 and 12 months and annually thereafter up to 5 years (in-person visit, telemedicine, telephone contact or review of clinical documentation), with regional mortality registries used to ascertain vital status when needed. Follow-up collects all-cause survival, cause of death, VTE recurrence, major and clinically relevant non-major bleeding, persistent functional limitation (modified Rankin Scale, exertional dyspnea, six-minute walk test when performed) and the development of chronic thromboembolic pulmonary hypertension (CTEPH).
OUTCOMES
Outcome definitions and time frames are reported in the Outcome Measures section.
DATA MANAGEMENT, QUALITY ASSURANCE, AND ETHICAL GOVERNANCE
Data collection is centralized using an electronic Case Report Form (eCRF) deployed on the REDCap (Research Electronic Data Capture) platform hosted on secure institutional servers at Azienda Ospedaliero-Universitaria Careggi (Florence, Italy).
- Privacy and Data Segregation: Strict GDPR compliance is maintained. Patient data are pseudonymized at source by the local site investigator using site-specific Subject IDs. The decoding key linking the alphanumeric ID to personal identifiers is maintained exclusively at the local participating hospital under the responsibility of the local Principal Investigator.
- Data Access Groups (DAGs): REDCap DAGs are enforced to compartmentalize site-level access, ensuring participating centers can exclusively view, enter, and edit their own center's records, with no unauthorized cross-center data visibility.
- Quality Assurance: The eCRF includes built-in validation rules (range and logic checks). The coordinating center performs regular central monitoring for inconsistencies, outliers and missing data, and discrepancies are resolved with each center through a formal query process. The Steering Committee reviews enrollment, data quality and protocol adherence every 6 months.
- Regulatory Framework: Protocol version 2.0 (7 May 2026) received a favourable opinion from the Comitato Etico Regione Toscana - Area Vasta Centro (CEAVC, register no. 30742_oss, meeting of 9 June 2026) for the sites of Azienda Ospedaliero-Universitaria Careggi and Azienda USL Toscana Centro. Participation of other national and international centers is subject to approval of a protocol amendment and of the competent local ethics committees. The study is conducted in accordance with the Declaration of Helsinki, Good Clinical Practice principles and applicable privacy regulations (including Article 110-bis of the Italian Privacy Code).
Study design
- Observational model
- Cohort
- Time perspective
- Other
- Target follow-up
- 5 Years
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Adults with acute pulmonary embolism | – | Other: Routine clinical care (no study intervention)Consecutive adults with objectively confirmed acute pulmonary embolism, in two cohorts: a retrospective cohort (diagnoses from 1 January 2023 until local ethics committee approval; data abstracted from medical records) and a prospective cohort (consecutive enrollment after approval, for 5 years; data collected during routine care). |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Consecutive adults with objectively confirmed acute pulmonary embolism diagnosed at participating hospitals, from emergency department presentation through hospitalization, including patients presenting with obstructive shock or cardiac arrest.
Key inclusion criteria (8 listed)
- Age 18 years or older at the time of presentation.
- Objectively confirmed diagnosis of acute pulmonary embolism (PE), with or without concomitant deep vein thrombosis (DVT) of the lower or upper extremities, confirmed by at least one of the following methods:
- Computed tomography pulmonary angiography (CTPA) demonstrating intraluminal filling defects in the pulmonary arterial tree;
- Ventilation/perfusion (V/Q) lung scintigraphy demonstrating high-probability mismatch;
- Conventional catheter-directed pulmonary angiography;
Key exclusion criteria (1 listed)
- Current active enrollment in an interventional experimental drug trial (blinded randomized clinical trial) where active drug allocation or protocol-mandated therapeutic regimen is unknown.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Routine clinical care (no study intervention)Also: Routine Clinical Practice, Usual CareObservational registry. Diagnostic and therapeutic management (laboratory tests, imaging, bedside ultrasound, anticoagulation, reperfusion and hemodynamic support) is entirely at the discretion of the treating physicians, according to routine institutional pathways and international guidelines. The registry only collects data generated in routine care. | Other | Adults with acute pulmonary embolism |
Primary outcome
All-cause mortality at 30 days
Time frame: 30 days after diagnosis
Proportion of patients who die from any cause within 30 days of the objectively confirmed diagnosis of acute pulmonary embolism. Vital status is ascertained from hospital records, review of clinical documentation and, when needed, regional mortality registries.
PE-related mortality at 30 days
Time frame: 30 days after diagnosis
Proportion of patients whose death within 30 days is adjudicated as a direct consequence of the index or a recurrent pulmonary embolism (PE). Fatal PE is defined as death occurring after objectively confirmed PE (index or recurrent event) in the absence of other identifiable causes, or confirmed at autopsy. For deaths occurring at home, information on the cause of death is actively sought.
8 secondary outcomes
Hemodynamic decompensation
Time frame: From diagnosis to hospital discharge or day 30, whichever comes first
All-cause mortality during follow-up
Time frame: 3 months, 12 months, and annually up to 5 years after diagnosis
PE-related mortality during follow-up
Time frame: 3 months, 12 months, and annually up to 5 years after diagnosis
Recurrent venous thromboembolism
Time frame: 30 days, 3 months, 12 months, and annually up to 5 years after diagnosis
Major bleeding (ISTH criteria)
Time frame: 30 days, 3 months, 12 months, and annually up to 5 years after diagnosis
Clinically relevant non-major bleeding
Time frame: 30 days, 3 months, 12 months, and annually up to 5 years after diagnosis
Chronic thromboembolic pulmonary hypertension (CTEPH)
Time frame: 30 days, 3 months, 12 months, and annually up to 5 years after diagnosis
Persistent functional limitation after pulmonary embolism (post-PE syndrome)
Time frame: 30 days, 3 months, 12 months, and annually up to 5 years after diagnosis
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Oct 2026.
- Background: PubMed 31615719Barco S, Mahmoudpour SH, Valerio L, Klok FA, Munzel T, Middeldorp S, Ageno W, Cohen AT, Hunt BJ, Konstantinides SV. Trends in mortality related to pulmonary embolism in the European Region, 2000-15: analysis of vital registration data from the WHO Mortality Database. Lancet Respir Med. 2020 Mar;8(3):277-287. doi: 10.1016/S2213-2600(19)30354-6. Epub 2019 Oct 12.
- Background: PubMed 26791063Jimenez D, de Miguel-Diez J, Guijarro R, Trujillo-Santos J, Otero R, Barba R, Muriel A, Meyer G, Yusen RD, Monreal M; RIETE Investigators. Trends in the Management and Outcomes of Acute Pulmonary Embolism: Analysis From the RIETE Registry. J Am Coll Cardiol. 2016 Jan 19;67(2):162-170. doi: 10.1016/j.jacc.2015.10.060.
- Background: PubMed 10227218Goldhaber SZ, Visani L, De Rosa M. Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet. 1999 Apr 24;353(9162):1386-9. doi: 10.1016/s0140-6736(98)07534-5.
- Background: PubMed 18296591Heit JA. The epidemiology of venous thromboembolism in the community. Arterioscler Thromb Vasc Biol. 2008 Mar;28(3):370-2. doi: 10.1161/ATVBAHA.108.162545. No abstract available.
- Background: PubMed 36017548Humbert M, Kovacs G, Hoeper MM, Badagliacca R, Berger RMF, Brida M, Carlsen J, Coats AJS, Escribano-Subias P, Ferrari P, Ferreira DS, Ghofrani HA, Giannakoulas G, Kiely DG, Mayer E, Meszaros G, Nagavci B, Olsson KM, Pepke-Zaba J, Quint JK, Radegran G, Simonneau G, Sitbon O, Tonia T, Toshner M, Vachiery JL, Vonk Noordegraaf A, Delcroix M, Rosenkranz S; ESC/ERS Scientific Document Group. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J. 2022 Oct 11;43(38):3618-3731. doi: 10.1093/eurheartj/ehac237. No abstract available.
- Background: PubMed 32767653Franco L, Becattini C, Beyer-Westendorf J, Vanni S, Nitti C, Re R, Manina G, Pomero F, Cappelli R, Conti A, Agnelli G. Definition of major bleeding: Prognostic classification. J Thromb Haemost. 2020 Nov;18(11):2852-2860. doi: 10.1111/jth.15048. Epub 2020 Sep 11.
- Background: PubMed 41135774Vanni S, Pelagatti L, Caviglioli C, Fabiani G, Caldi F, Pellegrino A, Ottaviani M, Innocenti F, Nazerian P. TELOS-plus identifies normotensive patients with pulmonary embolism at high risk of 30-day mortality. Int J Cardiol. 2026 Feb 1;444:133974. doi: 10.1016/j.ijcard.2025.133974. Epub 2025 Oct 22.
- Background: PubMed 31504429Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing GJ, Harjola VP, Huisman MV, Humbert M, Jennings CS, Jimenez D, Kucher N, Lang IM, Lankeit M, Lorusso R, Mazzolai L, Meneveau N, Ni Ainle F, Prandoni P, Pruszczyk P, Righini M, Torbicki A, Van Belle E, Zamorano JL; ESC Scientific Document Group. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020 Jan 21;41(4):543-603. doi: 10.1093/eurheartj/ehz405. No abstract available.
- Individual participant dataSharing planned: Yes. Pseudonymized individual participant data underlying published results may be shared with qualified researchers for methodologically sound proposals that fall within the scientific scope of the registry and do not overlap with analyses planned by the PERSEUS investigators. Sharing requires approval by the PERSEUS Steering Committee, approval by the competent ethics committee and a data transfer agreement with Azienda Ospedaliero-Universitaria Careggi, in compliance with the GDPR and the Italian Privacy Code.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Simone Vanni, MD, PhD principal investigator
Azienda Ospedaliero-Universitaria Careggi / University of Florence
Matteo Gabriele Monda, MD study director
Azienda Ospedaliero-Universitaria Careggi / University of Florence
16 sites in 3 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Venous Thromboembolism (VTE) and Chronic Thromboembolic Pulmonary Hypertension, run by Azienda Ospedaliero-Universitaria Careggi at 16 sites in 3 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 15 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 16 sites in Italy, Poland, Spain. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Simone Vanni, MD, PhD (+393666904459, simone.vanni@unifi.it), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
All-cause mortality at 30 days (time frame: 30 days after diagnosis). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07855679, which also lists 8 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Oct 2026.