Risk assessment, prognosis and guideline implementation in pulmonary arterial hypertension
Copyright ©ERS 2017..
Current European guidelines recommend periodic risk assessment for patients with pulmonary arterial hypertension (PAH). The aim of our study was to determine the association between the number of low-risk criteria achieved within 1 year of diagnosis and long-term prognosis.Incident patients with idiopathic, heritable and drug-induced PAH between 2006 and 2016 were analysed. The number of low-risk criteria present at diagnosis and at first re-evaluation were assessed: World Health Organization (WHO)/New York Heart Association (NYHA) functional class I or II, 6-min walking distance (6MWD) >440 m, right atrial pressure <8 mmHg and cardiac index ≥2.5 L·min-1·m-21017 patients were included (mean age 57 years, 59% female, 75% idiopathic PAH). After a median follow-up of 34 months, 238 (23%) patients had died. Each of the four low-risk criteria independently predicted transplant-free survival at first re-evaluation. The number of low-risk criteria present at diagnosis (p<0.001) and at first re-evaluation (p<0.001) discriminated the risk of death or lung transplantation. In addition, in a subgroup of 603 patients with brain natriuretic peptide (BNP) or N-terminal pro-brain natriuretic peptide (NT-proBNP) measurements, the number of three noninvasive criteria (WHO/NYHA functional class, 6MWD and BNP/NT-proBNP) present at first re-evaluation discriminated prognostic groups (p<0.001).A simplified risk assessment tool that quantifies the number of low-risk criteria present accurately predicted transplant-free survival in PAH.
| Errataetall: | |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:50 |
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| Enthalten in: |
The European respiratory journal - 50(2017), 2 vom: 03. Aug. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Boucly, Athénaïs [VerfasserIn] |
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| Links: |
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| Themen: |
114471-18-0 |
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| Anmerkungen: |
Date Completed 17.05.2018 Date Revised 09.04.2022 published: Electronic-Print CommentIn: Eur Respir J. 2017 Aug 3;50(2):. - PMID 28775053 Citation Status MEDLINE |
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| doi: |
10.1183/13993003.00889-2017 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM274490463 |
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| 245 | 1 | 0 | |a Risk assessment, prognosis and guideline implementation in pulmonary arterial hypertension |
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| 500 | |a Date Revised 09.04.2022 | ||
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| 500 | |a CommentIn: Eur Respir J. 2017 Aug 3;50(2):. - PMID 28775053 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright ©ERS 2017. | ||
| 520 | |a Current European guidelines recommend periodic risk assessment for patients with pulmonary arterial hypertension (PAH). The aim of our study was to determine the association between the number of low-risk criteria achieved within 1 year of diagnosis and long-term prognosis.Incident patients with idiopathic, heritable and drug-induced PAH between 2006 and 2016 were analysed. The number of low-risk criteria present at diagnosis and at first re-evaluation were assessed: World Health Organization (WHO)/New York Heart Association (NYHA) functional class I or II, 6-min walking distance (6MWD) >440 m, right atrial pressure <8 mmHg and cardiac index ≥2.5 L·min-1·m-21017 patients were included (mean age 57 years, 59% female, 75% idiopathic PAH). After a median follow-up of 34 months, 238 (23%) patients had died. Each of the four low-risk criteria independently predicted transplant-free survival at first re-evaluation. The number of low-risk criteria present at diagnosis (p<0.001) and at first re-evaluation (p<0.001) discriminated the risk of death or lung transplantation. In addition, in a subgroup of 603 patients with brain natriuretic peptide (BNP) or N-terminal pro-brain natriuretic peptide (NT-proBNP) measurements, the number of three noninvasive criteria (WHO/NYHA functional class, 6MWD and BNP/NT-proBNP) present at first re-evaluation discriminated prognostic groups (p<0.001).A simplified risk assessment tool that quantifies the number of low-risk criteria present accurately predicted transplant-free survival in PAH | ||
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| 700 | 1 | |a Savale, Laurent |e verfasserin |4 aut | |
| 700 | 1 | |a Jaïs, Xavier |e verfasserin |4 aut | |
| 700 | 1 | |a Cottin, Vincent |e verfasserin |4 aut | |
| 700 | 1 | |a Prevot, Grégoire |e verfasserin |4 aut | |
| 700 | 1 | |a Picard, François |e verfasserin |4 aut | |
| 700 | 1 | |a de Groote, Pascal |e verfasserin |4 aut | |
| 700 | 1 | |a Jevnikar, Mitja |e verfasserin |4 aut | |
| 700 | 1 | |a Bergot, Emmanuel |e verfasserin |4 aut | |
| 700 | 1 | |a Chaouat, Ari |e verfasserin |4 aut | |
| 700 | 1 | |a Chabanne, Céline |e verfasserin |4 aut | |
| 700 | 1 | |a Bourdin, Arnaud |e verfasserin |4 aut | |
| 700 | 1 | |a Parent, Florence |e verfasserin |4 aut | |
| 700 | 1 | |a Montani, David |e verfasserin |4 aut | |
| 700 | 1 | |a Simonneau, Gérald |e verfasserin |4 aut | |
| 700 | 1 | |a Humbert, Marc |e verfasserin |4 aut | |
| 700 | 1 | |a Sitbon, Olivier |e verfasserin |4 aut | |
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