1. Risk stratification, prognosis, and survival in a pulmonary arterial hypertension cohort in Latin America. A multicenter study.
- Author
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Diez M, Cáneva J, Diez A, Perna ER, Aimone D, Bosio M, Márquez LL, Brasca DG, Vulcano N, Daghero F, Burgos LM, Favaloro L, Escalante JP, Coronel ML, Fernández A, Chávez Á, and Secco L
- Subjects
- Humans, Female, Middle Aged, Male, Latin America epidemiology, Retrospective Studies, Familial Primary Pulmonary Hypertension, Risk Assessment, Prognosis, Pulmonary Arterial Hypertension diagnosis, Pulmonary Arterial Hypertension epidemiology, Pulmonary Arterial Hypertension therapy, Hypertension, Pulmonary diagnosis, Hypertension, Pulmonary epidemiology, Hypertension, Pulmonary therapy
- Abstract
Background: Pulmonary arterial hypertension (PAH) guidelines suggest that achieving a low-risk profile should be the treatment goal. Our aim was to assess a risk assessment strategy based on three non-invasive variables from the ESC/ERS 2015 guidelines in a Latin American cohort., Methods: 92 incident patients (mean [SD] age 47, 77% female, 53% idiopathic PAH) were included in this retrospective, multicenter study. Patients were stratified at baseline and at early follow-up, within the first year, using three non-invasive variables (WHO functional class, 6-minute walking distance, BNP/NT-proBNP) from the ESC/ERS 2015 risk assessment instrument. Median (IQR) follow-up was 3.11 years (3.01 years)., Results: At baseline assessment, 25% of patients were at low risk, 61.9% at intermediate-risk, and 13% at high-risk. At early follow-up (median 9.5 months), 56.5% of patients were at low-risk, 40.2% at intermediate-risk, and 3.2% at high-risk (p<0.001 vs. baseline). According to risk stratification at early follow-up, one, three and five-year overall survival was 100% in the low-risk group (no deaths at five-year follow-up), and 100%, 84% (95% CI: 72-98%), and 66% (95% CI: 48-90%) respectively in the intermediate-risk group, p = 0.0003. Mortality in the high-risk patients at early follow-up was 1/3 (33.3%). One, three, and five-year event-free survival (death or transplant or first hospitalization due to worsening PAH) based on early follow-up risk assessment was higher in the low-risk group, p = 0.0003., Conclusion: Our study validates a risk assessment strategy based on three non-invasive variables and confirms that early achievement of a low-risk profile should be the treatment goal., Competing Interests: Declaration of Competing Interest None., (Copyright © 2022 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)
- Published
- 2023
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